Synergistic effects of photodynamic therapy combined with antifungal agents on fungal infections: A systematic review
Abstract
BACKGROUND: Fungal infections are a major worldwide health concern requiring novel therapeutic strategies due to the emergence of antifungal drug resistance and frequent disease relapse. An emerging method for treating fungal infections that entails combining photodynamic therapy (PDT) with antifungal medications is believed to be more efficient and effective for fungal eradication.
OBJECTIVE: This study aimed to investigate the potential synergistic effects of antifungal agents combined with PDT and assess the treatment outcomes by synthesizing evidence from in vitro and in vivo studies, randomized controlled trials (RCTs), and case report/series.
METHODS: The literature search was conducted across PubMed and Web of Science from the inception of these databases to April 2026. Data on study design, treatment modalities, therapeutic outcomes, and prognosis were extracted.
RESULTS: A total of 68 articles were included, of which 30 were in vitro studies, 4 in vivo studies, 4 RCTs, and 30 were case report/series investigating the effect of PDT treatment with different photosensitizers combined with antifungal agents across diverse experimental and clinical settings. The majority of included studies reported a synergistic effect between antifungal drugs and PDT (n = 67). Notably, this evidence heavily relies on in vitro studies and case reports, with RCTs remaining sparse.
CONCLUSION: Our findings provide preliminary evidence suggesting a synergistic effect of PDT-antifungal…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 67 participants or records.
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