Abuhammour W, Habte-Gabr E
Department of Pediatrics, Hurley Medical Centre, Michigan State University-College of Human Medicine, Flint, Michigan, USA.
Indian J Pediatr. 2001 Jul;68(7):655-68. doi: 10.1007/BF02752281.
Anti-fungal agents are classified under two major headings, systematic and topical agents. Only systematic anti-fungal agents will be discussed in this chapter. Since the discovery in 1955, amphotericin B has been the cornerstone of anti-fungal treatment. It is active against most species of fungi. However, Candida lusitaniae, Pseudallescheria boydii, and fusarium spp have primary resistance to amphotericin B. Recently, new liposomal preparations of amphotericin B have been developed. They are less nephrotoxic. The azole family of anti-fungal includes two broad classes: the imidazoles (clotrimazote, ketoconazote, miconazole) and the triazoles (flucouazole and itracouazole). Imidazoles are still widely used for the treatment of superficial mycoses and vaginal candidiasis. The systematic triazoles are more slowly metabolized and have less effect on human synthesis than imidazoles, hence they are preferred for systemic therapy. Flucytosine is a fluorinated pyrimidine. Clinically, the principal use of flucytosine is as adjunctive therapy with amphotericin B in the treatment of candidial or cryptococcal diseases, Griseofuluin is derived from penicillium. It is fungistatic in vitro for species of dermatophytes. It is useful for the treatment of tinea capitis and tinea unginum.
抗真菌药物分为两大类，即全身用药和局部用药。本章仅讨论全身用抗真菌药物。自1955年发现以来，两性霉素B一直是抗真菌治疗的基石。它对大多数真菌种类都有活性。然而，葡萄牙念珠菌、波氏假阿利什霉和镰刀菌属对两性霉素B具有原发性耐药性。最近，已开发出两性霉素B的新型脂质体制剂。它们的肾毒性较小。抗真菌唑类家族包括两大类：咪唑类（克霉唑、酮康唑、咪康唑）和三唑类（氟康唑和伊曲康唑）。咪唑类仍广泛用于治疗浅表真菌病和阴道念珠菌病。与咪唑类相比，全身性三唑类代谢较慢，对人体合成的影响较小，因此它们更适合用于全身治疗。氟胞嘧啶是一种氟化嘧啶。临床上，氟胞嘧啶的主要用途是与两性霉素B联合治疗念珠菌病或隐球菌病。灰黄霉素源自青霉菌。它在体外对皮肤癣菌具有抑菌作用。它可用于治疗头癣和股癣。
