TreatmentUpdate60; Volume 7, No. 6 - June 1995
Sean Hosein

The release of newer antifungal drugs-fluconazole and itraconazole has been welcome because of their generally lower toxicity (than existing drugs) and ease of use (swallowing tablets versus getting intravenous therapy). Doctors are reporting more cases of fungal infections that are resistant to fluconazole and itraconazole, so some are experimenting with higher doses of those drugs or using intravenous amphotericin B (AmB). Researchers in the EU are performing laboratory experiments with fungi and combinations of antifungal drugs. Results from their work suggest that using fluconazole with AmB causes the drugs to interact and weakens their antifungal effect. Other researchers have confirmed their results in experiments with animals. They suggest that in cases where patients have widespread candida infection, combination therapy with AmB and azoles (including fluconazole, itraconazole, ketoconazole) "should be avoided". Information on the treatment of some fungal infections appears in the next issue of TreatmentUpdate.

REFERENCES:

1. Scheven M and Scheven M-L. Interaction between azoles and amphotericin B in the treatment of candidiasis. Clinical Infectious Diseases 1995;20:1079.

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