Viviani M A
Instituto di Igiene, Milano, Italien.
Med Klin (Munich). 1991 Dec;86 Suppl 1:19-22.
Since January 1985 more than 100 patients with deep fungal infections have been treated with itraconazole (200 to 400 mg/day) in Northern Italy. Evaluation of the drug efficacy and tolerance was possible in one patient with sporotrichosis, in 34 with aspergillosis, and in 36 with cryptococcosis (mainly patients positive for human immunodeficiency virus). Response to itraconazole alone was obtained in the case of sporotrichosis and in 24 of 34 patients with different forms of aspergillosis (of the 18 patients with invasive pulmonary aspergillosis, 15 were cured). Patients with cryptococcosis received itraconazole for active infection and/or for prevention of relapse. Active infection was treated successfully with itraconazole alone in nine of twelve patients and with itraconazole plus flucytosine in eight of ten patients. Of the 31 patients who received itraconazole maintenance therapy for up to 27 months, four (13%) had relapses; 14 (45%) did not have relapses, and decline of serum antigen was detected in twelve of them; and 13 (42%) were completely cured (serum antigen titer dropped to zero). With the exception of hypokalemia in one patient, itraconazole was well tolerated even in patients who received the drug for several months or years.
自1985年1月起,意大利北部已有100多名深部真菌感染患者接受了伊曲康唑治疗(200至400毫克/天)。对1例孢子丝菌病患者、34例曲霉病患者和36例隐球菌病患者(主要是人类免疫缺陷病毒阳性患者)进行了药物疗效和耐受性评估。孢子丝菌病患者以及34例不同类型曲霉病患者中的24例(18例侵袭性肺曲霉病患者中有15例治愈)单用伊曲康唑即取得了疗效。隐球菌病患者接受伊曲康唑治疗以控制活动性感染和/或预防复发。12例患者中有9例单用伊曲康唑成功治愈活动性感染,10例患者中有8例使用伊曲康唑加氟胞嘧啶治愈。在31例接受伊曲康唑维持治疗长达27个月的患者中,4例(13%)复发;14例(45%)未复发,其中12例检测到血清抗原下降;13例(42%)完全治愈(血清抗原滴度降至零)。除1例患者出现低钾血症外,即使是接受该药物治疗数月或数年的患者,伊曲康唑的耐受性也良好。