Quabeck K, Müller K D, Beelen D W, Dermoumi H, Kölbel M, Kraft J, Ansorg R, Schaefer U W
Klinik und Poliklinik für Knochenmarktransplantation, Universitätsklinikum Essen, Germany.
Mycoses. 1992 Sep-Oct;35(9-10):221-4. doi: 10.1111/j.1439-0507.1992.tb00851.x.
In an open study 31 patients undergoing bone marrow transplantation for various haematological diseases received fluconazole as prophylaxis or treatment of fungal infections. In 26 of these patients an antecedent oral prophylaxis with polyene antimycotics had failed to prevent infections with Candida species. Five of the 31 patients received fluconazole as primary prophylaxis because of non-compliance for polyene antimycotics. Fluconazole was administered orally at a daily dose of 100 mg and 200 mg, respectively (n = 29), or intravenously at a dose of 100 mg and 400 mg (n = 2). Cure or efficient prophylaxis was achieved in 22/31 patients (71%) after a median of 52 (9 to 493+) treatment days. In three patients (10%) Candida was eradicated but the infection reappeared 14-28 days after cessation of the drug; in 6 patients (20%) the infection was persistent or progressive. Four patients developed lethal Aspergillus infection while on fluconazole medication. A moderate and reversible elevation of liver function tests under therapy was observed in 9 patients and was possibly attributable to fluconazole in three of them (10%). One patient developed tremor which resolved after cessation of fluconazole. No other adverse drug reactions could be noted. We conclude that fluconazole is a relatively safe and effective drug for the prevention and treatment of superficial and, possibly, deep Candida infections in severely immunocompromised patients. However, it is presumably without preventive value in Aspergillus infections.
在一项开放性研究中，31例因各种血液系统疾病接受骨髓移植的患者接受氟康唑预防或治疗真菌感染。其中26例患者先前使用多烯类抗真菌药进行口服预防未能预防念珠菌属感染。31例患者中有5例因不依从多烯类抗真菌药而接受氟康唑作为一级预防。氟康唑分别以每日100 mg和200 mg的剂量口服（n = 29），或以100 mg和400 mg的剂量静脉注射（n = 2）。在中位治疗52天（9至493 +天）后，31例患者中有22例（71%）实现了治愈或有效预防。3例患者（10%）念珠菌被根除，但停药后14 - 28天感染复发；6例患者（20%）感染持续或进展。4例患者在接受氟康唑治疗期间发生致命的曲霉感染。9例患者在治疗期间观察到肝功能检查有中度且可逆的升高，其中3例（10%）可能归因于氟康唑。1例患者出现震颤，在停用氟康唑后缓解。未发现其他药物不良反应。我们得出结论，氟康唑是预防和治疗严重免疫功能低下患者浅表及可能的深部念珠菌感染的相对安全有效的药物。然而，它对曲霉感染可能没有预防价值。
