Rationale for combination antifungal therapy

The relentless increase of invasive fungal infections and poor outcomes ass ociated with available antifungal agents prompted the search for better the rapeutic strategies. Combining antifungal drugs was recommended as a means to enhance efficacy in a variety of invasive infections including cryptococ cosis, candidiasis, and aspergillosis. With the exception of cryptococcal m eningitis, data from controlled clinical trials supporting such combination s are sparse. Moreover, little consensus exists regarding which combination s are synergistic or antagonistic in vitro and in vivo. Based on available data, several principles underlie these combinations.