Relevant articles on the combination
therapy of
triazole and
echinocandin in IA, including the animal studies and clinical studies from January 1966 to October 2013, were searched on Web of Science, PubMed and Cochrane Library. The prolongation of survival of the combination
therapy of
triazole and
echinocandin in IA was performed as risk ratio (RR) with 95% confidence interval (95% CI).
RESULTS: Nine animal studies with a total of 1,582 animals and five clinical trials totaling 872 patients were included. The survival of the included animal studies with combination
therapy was significantly prolonged compared with
echinocandin alone [RR =2.26, (95% CI, 1.79-2.87; P<0.00001)], but no statistical difference compared with monotherapy of
triazole [RR =1.19, (95% CI, 0.98-1.44; P=0.08)]. Of the four human cohort studies, two studies observed that the combination
therapy of
triazole and
echinocandin was associated with a significant reduction in mortality compared with other treatments, and one study might be considered as a preferable
therapy [HR =0.58, (95% CI, 0.3-1.14; P=0.117)]. While another study revealed that there was no significant difference among the combination
therapy of
triazole and
echinocandin and either of the monotherapy. In the randomized clinical trial (RCT), of the 135 patients who received the combination
therapy, 39 died, while 55 died out of 142 patients who received monotherapy (P=0.08, 95% CI, -21.4, 1.09) by week 12.
CONCLUSIONS: