There is some clinical
evidence that amphotericin B given with either itraconazole
or miconazole may possibly be less effective than amphotericin B given alone, and the adverse effects may be greater.
Despite extensive in vitro
and animal data, it is not entirely clear whether or not azoles
inhibit the efficacy
of amphotericin B. Until more is known combined treatment should be limited to specific cases and the outcome should be very well monitored, being alert for a reduced antifungal response, or increasing LFTs.