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Fluconazole plus amphotericin B combinations are not contraindicated and may add benefit for the treatment of candidemia.

Invasive fungal infections must rank very high on the scale of clinical frustrations. They impede the recovery of many seriously ill patients who have otherwise benefited from cutting-edge medical and surgical techniques. They are often difficult to diagnose with certainty, and mortality rates remain higher than ideal despite a steadily expanding armory of broad-spectrum antifungal agents. In addition to the existing triazole antifungals (fluconazole and itraconazole) and amphotericin B (AmB), newer triazoles (voriconazole, posaconazole, and ravuconazole) and echinocandins (caspofungin, anidulafungin, and micafungin) are being developed for clinical use. This growing diversity of antifungal classes has renewed interest in the possibilities of therapy with antifungal combinations. By analogy with management of tuberculosis and HIV infection, a pharmaceutical attack designed to strike at ?'2 targets in the fungi may improve therapeutic outcomes.