Antifungal Combinations

Because of the poor in vitro activity of most of the antifungal drugs against zygomycetes and the limited in vivo efficacy of monotherapies in zygomycosis, combination of two or more drugs could be of interest. Several techniques are available to study antifungal combination in vitro (Vitale et al., 2005). Few studies either in vitro or in experimental animal models have been conducted so far. Evaluation of several combinations against 35 isolates of zygomycetes belonging to different species showed that amphotericin B interacted synergistically with rifampicin or with terbinafine against 69, and 20% of the isolates, respectively (Dannaoui et al., 2002a). Combination of terbinafine with vorico-nazole was also synergistic in 44% of the cases. In contrast combination of amphoter-icin B with flucytosine was indifferent. Antagonism was never observed. Two in vitro studies have evaluated combination of nikkomycin Z (a chitin synthase inhibitor) with an echinocandin (glucan synthase inhibitors) against a very limited number of R. oryzae isolates (Chiou et al., 2001; Stevens, 2000) and different results have been obtained. Anidulafungin in combination with nikkomycin Z showed synergy, although both drug were inactive when tested alone (Stevens, 2000). In contrast, micafungin combined with nikkomycin Z showed indifferent interaction for four strains of R. oryzae that were susceptible to nikkomycin Z alone (Chiou et al., 2001). Few studies have been carried out in animal models but have shown interesting results. In a model of pulmonary zygomy-cosis due R. oryzae it has been shown that fluconazole combined with a quinolone improved survival of mice, while none of these drugs were active alone (Sugar & Liu, 2000). In another study, synergy was observed between a lipid formulation of amphotericin B and caspofungin in a model of R. oryzae infection in diabetic mice (Spellberg et al., 2005b). By using an original Drosophila model of zygomycosis, it has been demonstrated that the combination of voriconazole with lovastatin was synergistic against R. oryzae and M. circinelloides (Chamilos et al., 2006).

Cure Your Yeast Infection For Good

Cure Your Yeast Infection For Good

The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.

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