[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-458999-105":59,"doc-detail-458999-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","in-vitro-evidence-to-support-amphotericin-b-and-flucytosine-combination-therapy-for-talaromycosis","In vitro evidence to support amphotericin B and flucytosine combination therapy for talaromycosis","","Talaromyces marneffei causes life-threatening talaromycosis with limited options and substantial mortality despite amphotericin B induction followed by itraconazole consolidation. This study evaluates whether combining amphotericin B (AmB) with flucytosine (5FC) strengthens antifungal activity. In vitro testing used validated antifungal susceptibility assays and checkerboard analysis across 60 clinical isolates, with MIC95, fractional inhibitory concentration indexing, and time-kill experiments to assess combination effects.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/in-vitro-evidence-to-support-amphotericin-b-and-flucytosine-combination-therapy-for-talaromycosis/458999/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/in-vitro-evidence-to-support-amphotericin-b-and-flucytosine-combination-therapy-for-talaromycosis/458999.png","ImageObject",300,407,{"name":92,"@type":93},"RuangKosong","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-05","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What problem does this study address in treating talaromycosis?","Question",{"text":112,"@type":113},"Talaromyces marneffei infections have limited treatment options, and standard amphotericin B followed by itraconazole still leads to 15%–30% mortality.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was the in vitro antifungal effect of amphotericin B and flucytosine measured?",{"text":117,"@type":113},"AmB and 5FC alone and in combination were tested against 60 clinical isolates using a validated colorimetric susceptibility assay, checkerboard method, MIC95 determination, and fractional inhibitory concentration index.",{"name":119,"@type":110,"acceptedAnswer":120},"What did the results show about the combination of AmB and 5FC?",{"text":121,"@type":113},"The study found full synergy in 4 isolates (7%) and indifference in 56 isolates (93%), with time-kill data showing synergy, greater than a 2-log10 reduction in colony forming units, and no observed antagonism.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},458999,1791109674,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},962090883219,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","OPEN ACCESS  \nCitation: Natesan Sambath H, Vitsupakorn S, Sreerama Reddy K, Brown L, Nguyen TTM, Burke M, et al. (2025) In vitro evidence to support amphotericin B and flucytosine combination therapy for talaromycosis. PLoS Negl Trop Dis 19(12): e0013884. [https://doi](https://doi). org/10.1371/journal.pntd.0013884  \nEditor: Joshua Nosanchuk, Albert Einstein College of Medicine, UNITED STATES OF AMERICA  \nReceived: October 15, 2025  \nAccepted: December 19, 2025  \nPublished: December 31, 2025  \nPeer Review History: PLOS recognizes the benefits of transparency in the peer review process; therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. The editorial history of this article is available here: [https://doi.org/10.1371/journal](https://doi.org/10.1371/journal). pntd.0013884  \nCopyright: © 2025 Natesan Sambath et al. This is an open access article distributed under the terms of the Creative Commons Attribution  License, which permits unrestricted use,  \nRESEARCH ARTICLE  \nIn vitro evidence to support amphotericin B and flucytosine combination therapy for talaromycosis  \nHeera Natesan Sambath1☯*, Shawin Vitsupakorn1,2☯, Kaushik Sreerama Reddy3☯, Lottie Brown4,5, Thu Thi Mai Nguyen1, Matthew Burke1, Jialin Liu1, Emily Evans6, Charles Giamberardino1, John Perfect1, Ngo Thi Hoa7,8,9, Thuy Le1,7*  \n1 Division of Infectious Diseases and International Health, Duke University School of Medicine, Durham, North Carolina, United States of America, 2 The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America, 3 Division of Rheumatology and Clinical Immunology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America, 4 Institute of Infection and Immunity, City St George’s University of London, School of Health & Medical Sciences, London, United Kingdom, 5 Clinical Infection Unit, St George’s Hospital, St George’s University Hospitals NHS Foundation Trust, London, United Kingdom, 6 Emory University School of Medicine, Atlanta, Georgia, United States of America, 7 Tropical Medicine Research Center for Talaromycosis, Biomedical Research and Diagnostics Center, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam, 8 Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam, 9 Centre for Tropical Medicine and Global health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom  \n☯ These authors contributed equally to this work.  \n* [Thuy.Le@duke.edu](Thuy.Le@duke.edu) (TL) and [Heera.Natesan.Sambath@duke.edu](Heera.Natesan.Sambath@duke.edu) (HNS)  \nAbstract  \nBackground  \nTalaromyces marneffei causes talaromycosis, a life-threatening fungal disease with limited treatment options. The standard treatment of amphotericin B (AmB) induction followed by itraconazole consolidation still results in 15% to 30% mortality. This study aimed to investigate the potential of AmB and flucytosine (5FC) combination therapy to enhance antifungal activity.  \nMethods  \nThe in vitro antifungal activity of AmB and 5FC alone and in combination against 60 T. marneffei clinical isolates was evaluated using a validated colorimetric antifungal susceptibility assay and the checkerboard method. The minimum inhibitory concentration (MIC) was defined as the lowest drug concentration inhibiting ≥ 95% fungal growth (MIC95) for bothAmB and 5FC. The combination effect between AmB and 5FC against T. marneffei was determined using fractional inhibitory concentration index. Combination effects were further tested using a time-kill assay.  \nPLOS Neglected Tropical Diseases | [https://doi.org/10.1371/journal.pntd.0013884](https://doi.org/10.1371/journal.pntd.0013884) December 31, 2025 1 / 13  \ndistribution, and reproduction in any medium, provided the original author and source are credited.  \nData availability statement: All relevant data are within the manuscript and its supporting  inf","cbCaiuGe897WRp6K","https://ap.wps.com/l/cbCaiuGe897WRp6K","pdf",1134740,13,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusions","[{\"question\":\"What problem does this study address in treating talaromycosis?\",\"answer\":\"Talaromyces marneffei infections have limited treatment options, and standard amphotericin B followed by itraconazole still leads to 15%–30% mortality.\"},{\"question\":\"How was the in vitro antifungal effect of amphotericin B and flucytosine measured?\",\"answer\":\"AmB and 5FC alone and in combination were tested against 60 clinical isolates using a validated colorimetric susceptibility assay, checkerboard method, MIC95 determination, and fractional inhibitory concentration index.\"},{\"question\":\"What did the results show about the combination of AmB and 5FC?\",\"answer\":\"The study found full synergy in 4 isolates (7%) and indifference in 56 isolates (93%), with time-kill data showing synergy, greater than a 2-log10 reduction in colony forming units, and no observed antagonism.\"}]","In vitro evidence to support amphotericin B and flucytosine combination therapy for talaromycosis | PDF",1790754964,33]