Tarumoto Norihito, Maesaki Shigefumi
Department of Infectious Disease and Infection Control, Saitama Medical University.
Nihon Rinsho. 2008 Dec;66(12):2373-7.
The oral agents for deep-seated mycoses that can be used in Japan are amphotericin B, flucytosine, fluconazole, itraconazole, and voriconazole. There are many guidelines, for example, the Japanese "Guidelines for the Diagnosis and Treatment of Deep-Seated Mycosis 2007", IDSA guidelines for candidiasis, aspergillosis, and so on, and these agents are used in antifungal therapy while referring to these guidelines. Recently relation between serum concentration of antifungal agent with effectiveness or side effects is found gradually. After understanding not only character of antifungal agents, spectrum, side effects, and adjustment according to renal function and other drug, but also new agents and other findings, we should treat mycoses. Especially, in the diabetic, it is necessary to note the rise of the blood level of the calcium channel blocker and oral antidiabetic agents while being using these drugs together with triazoles.
在日本可用于治疗深部真菌病的口服药物有两性霉素B、氟胞嘧啶、氟康唑、伊曲康唑和伏立康唑。有许多指南,例如日本的《2007年深部真菌病诊断和治疗指南》、美国感染病学会关于念珠菌病、曲霉病等的指南,在抗真菌治疗中参考这些指南使用这些药物。最近逐渐发现抗真菌药物血清浓度与疗效或副作用之间的关系。在了解抗真菌药物的特性、抗菌谱、副作用以及根据肾功能和其他药物进行调整,还有新药物和其他研究结果之后,我们才能治疗真菌病。特别是,糖尿病患者在将这些药物与三唑类药物联合使用时,必须注意钙通道阻滞剂和口服降糖药血药水平的升高。