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Decision Making in Antifungal Monotherapy versus Combination Therapy
Author(s) -
Lewis Russell E.
Publication year - 2006
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.26.6part2.61s
Subject(s) - antifungal , combination therapy , intensive care medicine , tolerability , medicine , clinical trial , medical physics , pharmacology , adverse effect , dermatology
The availability of new antifungal agents with novel mechanisms of action and improved tolerability has widened the possibilities for combination therapy for difficult‐to‐treat opportunistic mycoses. However, empiricism largely governs this therapy, especially in patients with invasive mould infections for whom there is a dire need to improve outcomes. Because of difficulties associated with the design and conduct of clinical trials of combination therapy for opportunistic mycoses, most studies are still performed in the laboratory or in animal models. Methods to assess combined antifungal effects in vitro and in animals are poorly standardized, and little evidence suggests that the data generated from these studies are relevant to treating patients. Even without solid evidence to support routine combination therapy, certain principles can guide its use in select patients.