Antifungals – Synergy, indifference and antagonism
drsuryabrata@gmail.comA combination of antifungals is often used in cases of difficult-to-treat infections. What is the evidence in the literature about synergy, antagonism and indifference?
| Drug 1 | Drug 2 | Candida | Aspergillus | Cryptococcus neoformans | |
| Amphotericin B | Echinocandin | Indifference (survival – NA) | Synergy, Indifference (Survival ↑) | Synergy (survival – NA) | |
| Amphotericin B | Flucytosine | Synergy, indifference (Survival ↑) | Synergy, indifference, antagonism (Survival ↑) | Synergy, indifference, antagonism (Survival ↑/↓) | |
| Amphotericin B | Azoles | Antagonism (Survival ↔/↓/↑) | Synergy, indifference, antagonism (Survival ↔/↓) | Indifference (Survival ↑/↓) | |
| Echinocandin | Azoles | Synergy (Ahmadi 2020) | Synergy, indifference (Survival ↑) | Indifference (survival – NA) | |
| Azoles | Flucytosine | Synergy, indifference, antagonism (Survival ↑) | Synergy, indifference (Survival ↑/↓) |
L.Ostrosky-Zeichner, Combination antifungal therapy: a critical review of the evidence, Clinical Microbiology and Infection Volume 14, Supplement 4, May 2008, Pages 65-70
