Tokimatsu Issei, Kadota Jun-ichi
Department of Infectious Diseases Oita University Faculty of Medicine, Japan.
Nihon Ishinkin Gakkai Zasshi. 2006;47(3):155-9. doi: 10.3314/jjmm.47.155.
Micafungin, a new class of the antifungal agent "echinocandin" released in 2002, and voriconazole, a new triazole antifungal agent released in 2005 in Japan have in vitro activities against Aspergillus spp. Results of large-scale clinical trials in Europe and the United States showed voriconazole to have superior efficacy against invasive pulmonary aspergillosis in comparison with conventional amphotericin B, and caspofungin, a member of the echinocandins, was effective as an empirical antifungal therapy in patients with persistent fever and neutropenia. In this way, choices of therapeutic medicine for aspergillosis are increasing more and more, and it is expected that the method of treatment will change greatly in future. On the other hand, we need to establish a new standard therapy for aspergillosis to avoid the clinical disruption caused by the variety of pharmaceutical choice caused. In this report, we describe the role of new antifungal agents for non-fumigatus Aspergillus infections, and the breakthrough in counteracting fungal infection using these new drugs.
米卡芬净是2002年上市的新型抗真菌药物“棘白菌素”类中的一种，伏立康唑是2005年在日本上市的新型三唑类抗真菌药物，它们对曲霉属真菌均具有体外活性。欧美大规模临床试验结果显示，与传统的两性霉素B相比，伏立康唑治疗侵袭性肺曲霉病疗效更佳，棘白菌素类的卡泊芬净对持续发热伴中性粒细胞减少的患者作为经验性抗真菌治疗有效。如此一来，曲霉病治疗药物的选择越来越多，预计未来治疗方法将发生很大变化。另一方面，我们需要建立曲霉病的新的标准治疗方法，以避免因药物选择多样而导致的临床混乱。在本报告中，我们阐述了新型抗真菌药物在非烟曲霉感染中的作用，以及使用这些新药在对抗真菌感染方面取得的突破。
