Combination antifungal therapy of murine aspergillosis: liposomal amphotericin B and micafungin

Objectives: AmBisome and micafungin were used alone and in combination in a series of studies designed to identify any additive or antagonistic effects of combination antifungal therapy. Methods: Immune-suppressed mice were infected either intravenously or intranasally with Aspergillus fumigatus. Micafungin, liposomal amphotericin B or both drugs together were administered for 7 days. Parameters of efficacy included survival and tissue burden of A. fumigatus. Results: Whilst each drug was effective in murine aspergillosis, additive effects were observed only in reduction of tissue burden in limited experimental conditions. No antagonism was seen. Conclusions: The present studies neither encourage nor discourage clinical use of combination therapy. Clinical trials are suggested before combined therapy is routinely adopted.