Hay R J
Department of Dermatology, Guy's Hospital, London, UK.
J Antimicrob Chemother. 1991 Jul;28 Suppl A:35-46. doi: 10.1093/jac/28.suppl_a.35.
At present there are weaknesses in the range and scope of antifungal chemotherapy. The development of a new group of azole drugs, the triazoles, has introduced antifungal agents with broad-spectrum activity which can be given by the oral route. Fluconazole is very well absorbed and has good penetration. While its principal activity is against yeasts and there are clinical data to support its use in candida and cryptococcus infections, little work has been completed on its clinical use in aspergillosis. Itraconazole is less well absorbed, but highly bound in tissue. Its spectrum of activity is somewhat broader than that of fluconazole and it is clinically active against superficial mycoses and some of the infections caused by pathogenic fungi such as Histoplasma capsulatum. There is some early evidence of efficacy in aspergillosis but more studies are required in neutropenic patients. Both drugs show promise but comparative assessments are sorely needed.
目前，抗真菌化疗的范围和广度存在不足。新一代唑类药物——三唑类的开发，引入了具有广谱活性且可口服给药的抗真菌剂。氟康唑吸收良好且具有良好的穿透力。虽然其主要活性针对酵母菌，并且有临床数据支持其在念珠菌和隐球菌感染中的应用，但关于其在曲霉病临床应用方面的研究工作很少。伊曲康唑吸收较差，但在组织中高度结合。其活性谱比氟康唑稍广，对浅表真菌病以及一些由致病性真菌如荚膜组织胞浆菌引起的感染具有临床活性。有一些早期证据表明其在曲霉病中有效，但在中性粒细胞减少患者中还需要更多研究。这两种药物都显示出前景，但迫切需要进行比较评估。
