Fortún Jesús
Servicio de Enfermedades Infecciosas, Hospital Ramón y Cajal, Madrid, España.
Enferm Infecc Microbiol Clin. 2011 Dec;29 Suppl 5:38-44. doi: 10.1016/S0213-005X(11)70042-8.
Increases in the rates of fungal infections, as well as their associated morbidity and mortality has led to a need for additional antifungal agents. The most common serious fungal agents in immunosuppressed and critically ill patients are Candida spp. and Aspergillus spp., although other emerging fungi must be considered. Rational, early systemic antifungal treatment should be based on diagnostic imaging techniques and conventional mycological and non-culture-based procedures. While the availability of new therapeutic options is an important advance, antifungal therapy has become increasingly complex. In addition to the available antifungal armamentarium, recent research has resulted in the introduction of three new antifungal agents: micafungin, anidulafungin, and posaconazole. This article provides an update, based on the latest scientific evidence, of the clinical efficacy, pharmacokinetics, safety and dosing of antifungal drugs administered in the management of Candida spp., Aspergillus spp., Cryptococcus spp., Zygomycetes, Scedosporium spp. and Fusarium spp.
真菌感染率及其相关的发病率和死亡率不断上升，这就需要更多的抗真菌药物。免疫抑制和重症患者中最常见的严重真菌病原体是念珠菌属和曲霉属，不过也必须考虑其他新出现的真菌。合理、早期的全身性抗真菌治疗应基于诊断成像技术以及传统的真菌学和非培养方法。虽然新治疗选择的出现是一项重要进展，但抗真菌治疗已变得日益复杂。除了现有的抗真菌药物库外，最近的研究还引入了三种新的抗真菌药物：米卡芬净、阿尼芬净和泊沙康唑。本文根据最新科学证据，对用于治疗念珠菌属、曲霉属、隐球菌属、接合菌、赛多孢菌属和镰刀菌属的抗真菌药物的临床疗效、药代动力学、安全性和给药剂量进行了更新。
