Combination therapy for the treatment of pulmonary mold infections

ABSTRACT

Introduction: Pulmonary mold infections are caused by ubiquitous organisms found in soil, water, and decaying vegetation, including Aspergillus spp., the Mucormycetes, hyaline molds, and dematiaceous (black) molds.

Areas covered: These infections are often a challenge to diagnose and even more difficult to treat. Recently, antifungal combination therapy has emerged as a promising strategy to treat some forms of invasive mycoses, including pulmonary mold infections. Historically, this approach has been limited due to non-uniform interpretation criteria, variations in pharmacodynamic/pharmacokinetic properties of antifungals used in combination, and an inability to predict clinical success based on in vitro data and animal models. However, recent advances have helped mitigate some of these challenges.

Expert commentary: In this paper, we explore what is known about the antifungal combination therapy in the treatment of pulmonary mold infections and explore how it may impact clinical practice. We pay particular attention to novel combinations and the challenges associated with the development of new antifungal agents

KEYWORDS:

• Aspergillosis
• mucormycosis
• echinocandin
• triazole
• polyene
• isavuconazole

Declaration of interest

M.W McCarthy has served as a consultant to Allergan. T.J Walsh has received research grants from Astellas, Cubist, Theravance, Allergan, The Medicines Company, Novartis, Merck and Pfizer. T.J Walsh has also served as a consultant to Astellas, Actavis, Contrafect, Drais, iCo, Novartis, Methylgene, Pfizer, Sigma-Tau and Tufts. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This paper was not funded.