Combination Therapy for Invasive Fungal Infections

  • Spencer J. LivengoodEmail author
  • Richard H. Drew
  • John R. Perfect
Pharmacology and Pharmacodynamics of Antifungal Agents (J Amsden, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Pharmacology and Pharmacodynamics of Antifungal Agents


Purpose of the Review

The purpose of this review is to summarize and evaluate relevant literature on combination antifungal therapy for invasive fungal infections (IFIs).

Recent Findings

Cryptococcal meningitis has the largest body and highest quality in support of combination therapy with amphotericin B and flucytosine. More recent data in treatment of invasive aspergillosis suggest combination therapy with voriconazole and echinocandins may be effective in select patients. Quality studies are needed to define combination therapy in rare mold infections.


Multiple strategies have been employed to optimize treatment of the growing incidence of IFIs. With exceptions as noted above, justification for the use of combination antifungal therapy is most often based on uncontrolled and/or underpowered studies, in vitro data, and case reports.


Combination antifungals Invasive fungal infections Antifungal synergy Aspergillosis Cryptococcus Candidiasis 


Compliance with Ethical Standards

Conflict of Interest

John Perfect reports grants and being a member of the advisory board for Merck; grants from Astellas, serving on the advisory board for F2G, serving on the advisory board, and consulting for Scynexis; grants from Pfizer; grants from Amplyx, serving on the advisory board and consulting for Ampili; and grants from Minnetronix, serving on the advisory board for Matinas outside the submitted work. Richard Drew reports expenses for CME presentation from American Society of Microbiology, consultant fees from Paratek, and publication royalties from UpToDate. Spencer Livengood declares no conflicts of interest relevant to this manuscript.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2020

Authors and Affiliations

  • Spencer J. Livengood
    • 1
    • 2
    Email author
  • Richard H. Drew
    • 1
    • 2
  • John R. Perfect
    • 1
  1. 1.Duke University Medical CenterDurhamUSA
  2. 2.Campbell University College of Pharmacy & Health SciencesBuies CreekUSA

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