Muller R J
Division of Pharmacy Services, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
Oncology (Williston Park). 2001 Nov;15(11 Suppl 9):21-5.
With the continuing increase in clinically important fungal disease, especially seen in the neutropenic patient, the need for new and improved systemic antifungal agents marches on. A pharmacy and therapeutics committee may select an antifungal agent based on these criteria: spectrum of action, pharmacokinetic profile, toxicity, potential for resistance, and cost. A number of agents are now available for treating deep fungal infections, including amphotericin B in conventional and liposomalformulations, and the triazoles itraconazole (Sporanox) and fluconazole (Diflucan). It is important to note that there is lack of agreement in practice over what constitutes ideal therapy. The lipidformulations of amphotericin B and the improved oral solution and new intravenous formulation of itraconazole are recent additions to therapeutic options that are already having a significant influence on drug selection and treatment practices.
随着临床上重要的真菌疾病持续增加,尤其是在中性粒细胞减少患者中出现的此类疾病,对新型和改良型全身性抗真菌药物的需求不断增长。药学与治疗学委员会可根据以下标准选择抗真菌药物:作用谱、药代动力学特征、毒性、耐药可能性以及成本。目前有多种药物可用于治疗深部真菌感染,包括常规剂型和脂质体制剂的两性霉素B,以及三唑类药物伊曲康唑(斯皮仁诺)和氟康唑(大扶康)。需要注意的是,在实践中对于什么构成理想治疗方案尚无共识。两性霉素B的脂质体制剂以及伊曲康唑改良口服溶液和新的静脉制剂是近期新增的治疗选择,它们已经对药物选择和治疗实践产生了重大影响。