Combination therapy in the treatment of experimental invasive fungal infection by Sarocladium (Acremonium) kiliense

Since human infections by Sarocladium (Acremonium) kiliense are usually refractory to antifungal therapy, combinations of drugs are an option that needs exploring. The antifungal activities of anidulafungin plus posaconazole or voriconazole and of amphotericin B plus voriconazole were evaluated and their efficacy was tested in a murine model of disseminated infection by three S. kiliense strains. The results showed that although efficacy was strain-dependent, these combinations work better, in general, than monotherapies. The best results were obtained with the combination of anidulafungin plus posaconazole, although the in vitro assay showed indifference or an antagonistic effect.