Niyongabo T, Leport C, Vildé J L
Service des Maladies infectieuses et tropicales, Groupe Hospitalier Bichat-Claude Bernard, Paris.
Presse Med. 1991 Oct 26;20(34):1677-81.
The scientific basis for using folinic acid in combination with the antiparasitic drugs prescribed to AIDS patients has been reviewed. In vitro and experimental data are unclear. On the basis of folinic acid metabolism and pharmacology and of clinical experience, we suggest that folinic acid should not be systematically added to the curative treatment of pneumocystosis with cotrimoxazole. Folinic acid may be added to prophylactic regimens using high-dose cotrimoxazole (i.e. 800 mg sulfamethoxazole twice a day) and in malnourished patients. It should be administered as soon as cytopenia occurs in the course of treatment. Concerning toxoplasmosis, the addition of folinic acid is recommended in doses of 10 to 20 mg/day in acute therapy and 5 to 10 mg/day in maintenance therapy. Dosage must be adjusted to the results of blood counts.
已对使用亚叶酸与开给艾滋病患者的抗寄生虫药物联合使用的科学依据进行了综述。体外和实验数据尚不清楚。基于亚叶酸的代谢、药理学以及临床经验，我们建议不应将亚叶酸系统性地添加到用复方新诺明治疗肺孢子菌病的方案中。亚叶酸可添加到使用高剂量复方新诺明（即每天两次，每次800毫克磺胺甲恶唑）的预防方案中，以及用于营养不良的患者。在治疗过程中一旦出现血细胞减少，就应立即给予亚叶酸。关于弓形虫病，建议在急性治疗中每天添加10至20毫克剂量的亚叶酸，在维持治疗中每天添加5至10毫克剂量。剂量必须根据血细胞计数结果进行调整。
