Yamada Harumi, Kotaki Hajime, Takahashi Takashi
Pharmacy Division, Institute of Medical Science, University of Tokyo, Tokyo 108-8639, Japan.
Expert Opin Pharmacother. 2003 Aug;4(8):1241-58. doi: 10.1517/14656566.4.8.1241.
Incidences of fungal pneumonias have increased in immunocompromised patients with HIV infection or receiving bone marrow replacement or solid organ transplantation. Fungal pneumonias including aspergillosis, cryptococcosis, candidiasis, coccidioidomycosis, histoplasmosis and blastomycosis are one of the major causes of morbidity and mortality among the immunosuppressed hosts. Therefore, clinicians should consider the most appropriate and aggressive treatment of fungal pneumonias in this population. This report outlines the state of the art in the treatment of fungal pneumonias and discusses recent advances in antifungal therapy. Practice guidelines for the treatment with commonly used antifungal agents including amphotericin B, fluconazole, itraconazole, ketoconazole and flucytosine, are very useful for clinicians to manage the diseases appropriately. Echinocandins and second-generation triazoles will hopefully help clinicians to overcome the limitations of the current therapy.
在感染人类免疫缺陷病毒（HIV）的免疫功能低下患者，或接受骨髓置换或实体器官移植的患者中，真菌性肺炎的发病率有所上升。包括曲霉病、隐球菌病、念珠菌病、球孢子菌病、组织胞浆菌病和芽生菌病在内的真菌性肺炎，是免疫功能低下宿主发病和死亡的主要原因之一。因此，临床医生应考虑对该人群的真菌性肺炎进行最恰当且积极的治疗。本报告概述了真菌性肺炎治疗的最新进展，并讨论了抗真菌治疗的近期进展。关于常用抗真菌药物（包括两性霉素B、氟康唑、伊曲康唑、酮康唑和氟胞嘧啶）治疗的实践指南，对临床医生合理管理这些疾病非常有用。棘白菌素类药物和第二代三唑类药物有望帮助临床医生克服当前治疗的局限性。
