Das S, Shivaprakash M R, Chakrabarti A
Division of International Medicine and Infectious Diseases, Weil Medical College of Cornell University, New York, NY, USA.
Indian Pediatr. 2009 Mar;46(3):225-31.
Clinical needs for new antifungal agents have steadily increased with the rise and alteration in spectrum of invasive mycoses in children and neonates having AIDS, malignancies and undergoing immunosuppressive therapies. Several new options are now available for management of serious fungal infections. The aim of this review is to summarize the key features of the new antifungal agents and novel targets being investigated for the treatment of fungal infections, with special reference to its use in the treatment of pediatric fungal infections. New triazoles have broad spectrum of activity with voriconazole presently being the drug of choice against invasive aspergillosis, and posaconazole is the possible first substitute of amphotericin B against zygomycosis. Echinocandins with new mode of action of inhibition of fungal cell wall polysaccharide synthesis are effective in treating candidemia and invasive candidiasis. Some of these agents are however, still awaiting FDA approval for their use in pediatric practice.
随着患有艾滋病、恶性肿瘤以及接受免疫抑制治疗的儿童和新生儿侵袭性真菌病的范围扩大和变化，对新型抗真菌药物的临床需求稳步增加。目前有几种新的选择可用于治疗严重的真菌感染。本综述的目的是总结新型抗真菌药物的关键特性以及正在研究的用于治疗真菌感染的新靶点，特别提及它们在儿科真菌感染治疗中的应用。新型三唑类药物具有广谱活性，伏立康唑目前是治疗侵袭性曲霉病的首选药物，泊沙康唑是对抗接合菌病可能替代两性霉素B的首选药物。具有抑制真菌细胞壁多糖合成新作用模式的棘白菌素类药物在治疗念珠菌血症和侵袭性念珠菌病方面有效。然而，其中一些药物仍在等待美国食品药品监督管理局（FDA）批准用于儿科临床。
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