Van Cutsem J
Department of Bacteriology and Mycology, Janssen Research Foundation, Beerse, Belgium.
Med Klin (Munich). 1991 Dec;86 Suppl 1:5-8.
Itraconazole is a lipophilic triazole with potent in vitro activity. It is also highly efficacious after topical, oral and parenteral administration. The antifungal activity of itraconazole has been evaluated against more than 6500 different strains, belonging to more than 260 fungal species using the serial decimal dilution test in fluid media (BHI broth). Candida, Torulopsis, Cryptococcus, Pityrosporum (Dixon broth), various other yeasts, dermatophytes, Aspergillus, Penicillium, Sporothrix, dimorphic fungi (MP and YP), Phaeohyphomycetes, Entomophthorales and various Hyalohyphomycetes are sensitive. Most strains of Fusarium and Zygomycetes are poorly sensitive. Itraconazole was administered orally and parenterally in normal and in immunocompromised guinea-pigs, infected with C. albicans, Cr. neoformans, H. duboisii, Sp. schenckii, P. marneffei and A. fumigatus. It was efficacious both in survival of the animals and in eliminating the fungi from the various tissues. Itraconazole was superior to fluconazole in candidosis, cryptococcosis, sporotrichosis and aspergillosis, to amphotericin B and to flucytosine in candidosis, cryptococcosis and aspergillosis. No comparative studies were done up to now for the other deep mycoses. The results of combination therapy of itraconazole with fluconazole in cryptococcosis were indifferent, with 5-flucytosine or amphotericin B, additive or synergistic in systemic candidosis, cryptococcosis and aspergillosis. No drug-related side-effects were observed after oral or parenteral administration of itraconazole.
伊曲康唑是一种具有强大体外活性的亲脂性三唑类药物。局部、口服和肠胃外给药后它也具有高效性。使用液体培养基(脑心浸液肉汤)中的连续十进制稀释试验,已针对属于260多种真菌的6500多种不同菌株评估了伊曲康唑的抗真菌活性。念珠菌属、球拟酵母菌属、隐球菌属、马拉色菌属(狄克逊肉汤)、各种其他酵母菌、皮肤癣菌、曲霉属、青霉属、申克孢子丝菌、双相真菌(MP和YP)、暗色丝孢霉、虫霉目和各种透明丝孢霉均敏感。大多数镰刀菌属和接合菌纲菌株敏感性较差。在感染白色念珠菌、新型隐球菌、杜波依斯隐球菌、申克孢子丝菌、马尔尼菲青霉和烟曲霉的正常和免疫受损豚鼠中口服和肠胃外给予伊曲康唑。它在动物存活以及从各种组织中清除真菌方面均有效。在念珠菌病、隐球菌病、孢子丝菌病和曲霉病方面,伊曲康唑优于氟康唑;在念珠菌病、隐球菌病和曲霉病方面,伊曲康唑优于两性霉素B和氟胞嘧啶。目前尚未对其他深部真菌病进行比较研究。伊曲康唑与氟康唑联合治疗隐球菌病的结果无差异,与5-氟胞嘧啶或两性霉素B联合治疗系统性念珠菌病、隐球菌病和曲霉病时具有相加或协同作用。口服或肠胃外给予伊曲康唑后未观察到与药物相关的副作用。