COMBINATION AND SEQUENTIAL ANTIFUNGAL THERAPY FOR INVASIVE ASPERGILLOSIS: REVIEW OF ALL IN VITRO, IN VIVO, AND CLINICAL ANTIFUNGAL TREATMENT

Steinbach WJ

Author address: 

Pediatric Infectious Diseases, Duke University Duke University Mycology Research Unit, Durham, NC

Abstract: 

The incidence of invasive aspergillosis (IA) has increased significantly in the last several decades and the overall survival rate among patients treated with amphotericin B remains dismal. A recent practice survey found that combination antifungal regimens were seldom used for invasive aspergillosis. There has been a recent surge in the development of newer antifungals and drawing from other infectious disease examples combination antifungal therapy is logical. Presently, no controlled clinical trial supports combination therapy for IA and its efficacy has not been conclusively established. The sparse data on combination or sequential antifungal therapy for IA depict interactions ranging from synergy to antagonism. This is the first study to synthesize the available data on combination and sequential antifungal therapy for IA, reviewing all in vitro, in vivo, and clinical published reports and recent abstracts. Methods and Results. A MEDLINE search was performed from 1966 - 2001. Combination reports from 1966 until 1990 are utilized from a previous review of 2,121 published cases by Denning and Stevens and supplemented with an additional 4,160 cases of IA treatment in the last 12 years. Clinical reports were excluded if antifungals were not used at accepted treatment doses or treatment was
2002

abstract No: 

none

Full conference title: 

12th Annual Focus on Fungal Infections
    • FFI 12th (2002)