Glöckner A
BDH-Klinik Greifswald GmbH, Deutschland.
Internist (Berl). 2011 Sep;52(9):1118-24, 1126. doi: 10.1007/s00108-011-2873-9.
Invasive fungal infections have gained importance in many areas of clinical medicine and represent a growing diagnostic and therapeutic challenge for clinicians. During the last decade, several new antifungals were introduced into routine therapy: two second-generation triazoles and the new class of echinocandins. These innovative drugs showed convincing efficacy and favorable safety in randomized clinical trials. Consequently, they were integrated in recent therapeutic guidelines, often replacing former standard drugs as first-line options. The echinocandins (anidulafungin, caspofungin, micafungin) primarily have gained a central role in the treatment of invasive Candida infections, while the novel triazoles voriconazole and posaconazole established themselves as the current mainstays in therapy and prophylaxis of invasive fungal infections, particularly aspergillosis, in hemato-oncologic high-risk patients.
侵袭性真菌感染在临床医学的许多领域变得愈发重要,对临床医生而言,其诊断和治疗挑战日益增加。在过去十年中,几种新型抗真菌药物被引入常规治疗:两种第二代三唑类药物以及新型棘白菌素类药物。这些创新药物在随机临床试验中显示出令人信服的疗效和良好的安全性。因此,它们被纳入了近期的治疗指南,常常取代以前的标准药物成为一线选择。棘白菌素类药物(阿尼芬净、卡泊芬净、米卡芬净)在侵袭性念珠菌感染的治疗中主要发挥核心作用,而新型三唑类药物伏立康唑和泊沙康唑已成为血液肿瘤高危患者侵袭性真菌感染(尤其是曲霉病)治疗和预防的当前主要药物。