Advances and updates in antibiotic combination therapy.

Area of Science:

• Infectious Diseases
• Pharmacology
• Clinical Microbiology

Background:

• Antibiotic combination therapy is a common practice but lacks a robust scientific foundation.
• Existing evidence is fragmented and does not fully address complex modern infectious disease scenarios.

Purpose of the Study:

• To critically re-evaluate the role of antibiotic combination therapy.
• To propose a pathogen-specific approach for antibiotic use, particularly in severe infections.

Main Methods:

• Focused PubMed search of studies from 2018-2025.
• Review of antibiotic combinations for key gram-positive and gram-negative pathogens.

Main Results:

• Strong indications for combination therapy are limited to specific syndromes like endocarditis or toxic shock.
• Insufficient data exists for definite clinical indications in severe gram-negative infections.

Conclusions:

• Antibiotic combination therapy should be reserved for specific clinical situations.
• Further randomized clinical trials, including novel antibiotics, are necessary to clarify its role, especially for gram-negative pathogens.