Kontoyiannis Dimitrios P, Lewis Russell E
Departments of Infectious Diseases, Infection Control and Employee Health, The University of Texas M.D. Anderson Cancer Center, Box 402, 1515 Holcombe Blvd, Houston TX, USA.
Drug Resist Updat. 2003 Oct;6(5):257-69. doi: 10.1016/j.drup.2003.08.003.
Despite potential benefits, few objective clinical data (with the exception of cryptococcocal meningitis) are available supporting the routine use of combination antifungal regimens in patients with invasive mycoses, importantly aspergillosis or candidiasis. There is considerable debate on what constitutes synergy or antagonism in vitro and whether these laboratory findings are translated to beneficial interactions in patients. Given the lack of rigorous clinical data, a better understanding of the important concepts for the justification of the clinical and pharmacoeconomic threshold of antifungal therapy is needed. Such concepts include standardized methods for screening antifungal combinations in culture or in animals and collaborative efforts to collect clinical data on the efficacy and safety of combination regimens.
