Abstract
Historically poor outcomes have generated many efforts toward improving outcomes of invasive pulmonary aspergillosis in immunosuppressed hosts, by improving prevention strategies, use of early diagnostics, and employing new antifungals, including combinations of drugs. The latter approach is supported by theoretical benefits in both the antimicrobial activity and pharmacologic properties of drugs, with in vitro and animal studies suggesting potential utility. Because drug combinations can also increase toxicities, interactions, and costs, demonstrating therapeutic effects in clinical trials is imperative. Here, clinical data evaluating combination antifungal therapy for aspergillosis are reviewed. Results to date suggest potential benefit of antifungal combinations, especially those including azoles and echinocandins, but conclusions are not definitive. This important topic warrants further study.
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