{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T13:48:43Z","timestamp":1790516923869,"version":"4.1.0"},"reference-count":35,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,5,2]],"date-time":"2017-05-02T00:00:00Z","timestamp":1493683200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine whether combination therapy would improve therapeutic outcome in eumycetoma caused by <jats:italic>Madurella mycetomatis<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Survival, colony\u2010forming units (<jats:styled-content style=\"fixed-case\">CFU<\/jats:styled-content>), melanisation and histopathology in <jats:italic>M. mycetomatis\u2010<\/jats:italic>infected <jats:italic>Galleria mellonella<\/jats:italic> larvae treated with amphotericin B, itraconazole, terbinafine or combinations thereof were determined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to larvae treated with 5% glucose, enhanced survival was obtained when <jats:italic>M. mycetomatis\u2010<\/jats:italic>infected larvae were treated with amphotericin B, but not when they were treated with itraconazole or terbinafine. Combination therapy did not increase survival compared to 5% glucose\u2010treated larvae, itraconazole\u2010treated larvae or terbinafine\u2010treated larvae. Compared to amphotericin B monotreatment, a significant decrease in survival was noted when this therapy was combined with either itraconazole or terbinafine. <jats:styled-content style=\"fixed-case\">CFU<\/jats:styled-content>, melanisation and histopathology did not differ between monotherapy, combination therapy or 5% glucose\u2010treated larvae.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Combining different classes of antifungal agents did not enhance the survival of <jats:italic>M. mycetomatis\u2010<\/jats:italic>infected <jats:italic>G. mellonella<\/jats:italic> larvae. Instead of improving the therapeutic outcome, combining either itraconazole or terbinafine with amphotericin B resulted in significantly lower survival rates of infected larvae than amphotericin B monotherapy. This experimental study does not provide support for the use of combined amphotericin B and itraconazole, combined itraconazole and terbinafine or combined terbinafine and amphotericin B and should be confirmed in other animal models.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.12871","type":"journal-article","created":{"date-parts":[[2017,3,25]],"date-time":"2017-03-25T10:31:16Z","timestamp":1490437876000},"page":"696-702","source":"Crossref","is-referenced-by-count":19,"title":["Combining two antifungal agents does not enhance survival of <i>Galleria mellonella<\/i> larvae infected with <i>Madurella mycetomatis<\/i>"],"prefix":"10.1111","volume":"22","author":[{"given":"Kimberly","family":"Eadie","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology and Infectious Diseases ErasmusMC Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florianne","family":"Parel","sequence":"additional","affiliation":[{"name":"Department of 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