Kauffman Carol A
Division of Infectious Diseases, Department of Internal Medicine, University of Michigan Medical School, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI 48105, USA.
Curr Opin Microbiol. 2006 Oct;9(5):483-8. doi: 10.1016/j.mib.2006.08.001. Epub 2006 Aug 9.
Several new options are now available for treating serious fungal infections. All three echinocandin agents currently available have been shown in randomized, blinded clinical trials to be efficacious in treating candidemia and invasive candidiasis. By contrast, the demonstrated efficacy of the echinocandins for the treatment of invasive aspergillosis has been based on historically controlled salvage treatment trials in patients failing or intolerant of other therapies. The new triazole agents, voriconazole and posaconazole, have a broad spectrum of antifungal activity. Voriconazole has become the agent of choice for invasive aspergillosis. On the basis of compassionate treatment data, posaconazole appears to be effective for treatment of zygomycosis. These agents have also been shown to be effective in the treatment of non-Aspergillus mould infections, several of the endemic mycoses and serious Candida infections.
目前有几种新的选择可用于治疗严重的真菌感染。目前可用的三种棘白菌素类药物在随机、盲法临床试验中已显示对治疗念珠菌血症和侵袭性念珠菌病有效。相比之下，棘白菌素类药物对侵袭性曲霉病的已证实疗效是基于对其他治疗无效或不耐受的患者进行的历史对照挽救治疗试验。新型三唑类药物伏立康唑和泊沙康唑具有广泛的抗真菌活性。伏立康唑已成为侵袭性曲霉病的首选药物。根据同情用药治疗数据，泊沙康唑似乎对治疗接合菌病有效。这些药物也已显示对非曲霉属霉菌感染、几种地方性真菌病和严重念珠菌感染有效。
