Perfect John R., Cox Gary M.
Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, USA
Drug Resist Updat. 1999 Aug;2(4):259-269. doi: 10.1054/drup.1999.0090.
Cryptococcus neoformans has become a major opportunistic fungal pathogen worldwide. Successful treatment of invasive disease with this fungus has used amphotericin B, flucytosine and various azoles. However, treatment failures continue to occur for a variety of reasons including direct antifungal drug resistance. Issues and mechanisms for antifungal drug resistance in Cryptococcus neoformans are reviewed. Furthermore, approaches and strategies for prevention and treatment of antifungal drug resistance are identified and these include host immune modulation, dose optimization, prophylaxis/empirical regimens, improved drug delivery systems such as lipid preparations of amphotericin B, surgery, combination antifungal treatments and development of new antifungal agents. Copyright 1999 Harcourt Publishers Ltd.
新型隐球菌已成为全球主要的机会性真菌病原体。使用两性霉素B、氟胞嘧啶和各种唑类药物成功治疗了这种真菌引起的侵袭性疾病。然而，由于包括直接抗真菌药物耐药性在内的多种原因，治疗失败仍不断发生。本文综述了新型隐球菌抗真菌药物耐药性的问题及机制。此外，还确定了预防和治疗抗真菌药物耐药性的方法和策略，包括宿主免疫调节、剂量优化、预防/经验性治疗方案、改进的药物递送系统（如两性霉素B的脂质制剂）、手术、联合抗真菌治疗以及开发新的抗真菌药物。版权所有1999年哈考特出版有限公司。
