Amphotericin B and Posaconazole Combination

The combination of amphotericin B and posaconazole represents an antifungal therapy approach used primarily for serious fungal infections, including candidiasis, zygomycosis (mucormycosis), and cryptococcosis. Amphotericin B disrupts fungal cell membranes, while posaconazole, a triazole antifungal, inhibits ergosterol synthesis. This combination appears to have complementary effects, often showing greater efficacy than monotherapy. For systemic candidiasis, studies found that a significant percentage of combinations were more effective than individual drugs. In murine models of disseminated zygomycosis and in clinical case reports, this combination has shown promise by prolonging survival and reducing tissue burden. It is primarily used in immunocompromised patients with invasive fungal infections, especially those with hematologic malignancies, stem cell transplant recipients, or prolonged neutropenia, as well as for the treatment of mucormycosis and refractory fungal infections. Lipid formulations of amphotericin B are typically preferred to reduce toxicity. Standard dosing often includes posaconazole at 800 mg/day and liposomal amphotericin B at 3 mg/kg or higher.

Other names

Amphotericin B plus posaconazole