Combination therapy of murine invasive candidiasis with fluconazole and amphotericin B

Antimicrob Agents Chemother. 1995 Mar;39(3):598-601. doi: 10.1128/AAC.39.3.598.

Abstract

A study was performed to assess the in vivo relevance of the in vitro antagonism between fluconazole and amphotericin B against Candida albicans. Combinations of fluconazole and amphotericin B were explored for their efficacies against acute (100% mortality in 2 to 5 days) or less acute (100% mortality in 30 days) invasive candidiasis infections in mice with healthy immune systems and immunocompromised mice. Treatment efficacy was assessed by protection from mortality and/or a reduction in the fungal burden in tissue. In models of acute infection in mice with healthy immune systems or less acute infection in immunocompromised mice, combinations of fluconazole and amphotericin B were superior to fluconazole alone, and the effects were at least additive. Combination therapy was at least as efficacious as amphotericin B alone. In a different model of less acute infection in mice with healthy immune systems, combinations of fluconazole and amphotericin B showed no interactions and were no better than either drug alone. We conclude that combination therapy with fluconazole and amphotericin B is not antagonistic in vivo, in contrast to published in vitro studies, and, consequently, suggest that combination therapy should be considered in the management of clinical candidiasis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amphotericin B / administration & dosage
  • Amphotericin B / therapeutic use*
  • Animals
  • Candidiasis / drug therapy*
  • Candidiasis / immunology
  • Candidiasis / microbiology
  • Cyclophosphamide
  • Drug Combinations
  • Female
  • Fluconazole / administration & dosage
  • Fluconazole / therapeutic use*
  • Kidney / microbiology
  • Male
  • Mice
  • Mice, Inbred ICR
  • Mice, Inbred Strains
  • Neutropenia / chemically induced
  • Neutropenia / microbiology

Substances

  • Drug Combinations
  • Amphotericin B
  • Cyclophosphamide
  • Fluconazole