Kurnatowski Piotr, Kurnatowska Agnieszka K
Katedra Biologii i Genetyki Medycznej, Zakład Biologii i Parazytologii Lekarskiej Uniwersytetu Medycznego w Lodzi.
Otolaryngol Pol. 2007;61(3):280-5. doi: 10.1016/S0030-6657(07)70426-2.
Fungi, in comparison with other pathogenic factors, have high pathogenicity. The number of fungal species which are able to infect people is over 500. The upper respiratory tract and ear have permanent contact with external environment which makes their ontocenoses open to continuous exchange of microorganisms of which they consist. In etiology of inflammatory processes 21 species which belonging to 3 genera (Zygomycota, Ascomycota, Basidiomycota) of fungi play important role. Administration of antifungal drugs can be: prophylactic, empiric preemptive and therapeutic. Physicians may prescribe antibiotics (mainly pollens: amphotericin B, natamycin and nystatin) and chemiotherapeutics (mainly azoles and fluorpirymidins, pigments, chlorhexidine and chlorquinaldol). In ENT practice topical and systemic drugs can be administrated. Topical lozenges include amphotericin B, clotrimazole, chlorhexidine or chlorquinaldol and oral gels: nystatin and miconazole. Some of drugs are in the form of suspension/solution, which can be used for inhalation, into the sinus, for swabbing or for lavage: amphotericin B, natamycin, nystatin, clotrimazol, flucytosine, miconazole, fluconazole, vorykonazole, caspofungin. It should be underlined that only a few of dugs can be absorbed from the digestive tract: flucytosine, fluconazole, itraconazole, ketoconazole, miconazole, vorykonazole.
与其他致病因素相比，真菌具有很高的致病性。能够感染人类的真菌种类超过500种。上呼吸道和耳朵与外部环境有持续接触，这使得它们的群落能够不断地与构成它们的微生物进行交换。在炎症过程的病因学中，属于3个真菌属（接合菌门、子囊菌门、担子菌门）的21种真菌起着重要作用。抗真菌药物的给药方式可以是：预防性、经验性抢先治疗和治疗性。医生可能会开抗生素（主要是多烯类：两性霉素B、那他霉素和制霉菌素）和化学治疗药物（主要是唑类和氟嘧啶类、色素、洗必泰和氯喹那多）。在耳鼻喉科实践中，可以使用局部和全身药物。局部含片包括两性霉素B、克霉唑、洗必泰或氯喹那多，口服凝胶有制霉菌素和咪康唑。有些药物是混悬液/溶液形式，可用于吸入、鼻窦给药、擦拭或灌洗：两性霉素B、那他霉素、制霉菌素、克霉唑、氟胞嘧啶、咪康唑、氟康唑、伏立康唑、卡泊芬净。需要强调的是，只有少数药物能从消化道吸收：氟胞嘧啶、氟康唑、伊曲康唑、酮康唑、咪康唑、伏立康唑。
