The overall prognosis of primary amoebic meningoencephalitis remains poor. The results of this study support previous finding that amphotericin B is the most efficacious drug against the Naegleria species in in vitro testing. In additon, the methyl ester of amphotericin B, a new derivative, also appears to be an effective agent. Of the drug combinations studied, amphotericin B plus minocycline and amphotericin B plus tetracycline showed synergy. The clinical significance of these findings remains to be determined.A strain of Naegleria fowleri (HB-1) was tested in vitro for susceptibility to amphotericin B (AMB), the methyl ester of AMB, miconazole, minocycline, and tetracycline, both singly and in combination with one another. The mean minimal inhibitory concentrations (MICs), defined as an absence of cytopathic effect by amoebae on monkey kidney cell (MKC) monolayers, were, respectively: AMB, 0.024 ug/ml; methyl ester of AMB, 0.103 ug/ml; minocycline, 2.8 ,ug/ ml; miconazole, 6.25 lAg/ml; and tetracycline, 10.0 ,ug/ml. Synergism