Watanabe A, Ohizumi K, Motomiya M, Takeuchi K, Yoshida T, Ida S, Miura Y, Nishioka K, Tanno Y, Takishima T
Department of Internal Medicine, Tohoku University.
Jpn J Antibiot. 1990 Aug;43(8):1392-401.
We evaluated the therapeutic efficacy of miconazole (MCZ, Florid-F inj.), a new antifungal agent for parenteral use, in deep-seated fungal infections of respiratory tract system. A daily dose of 400-1,800 mg of MCZ was given intravenously for 12-38 days (mean: 23.4 days) to 7 patients: 2 patients with pulmonary aspergillosis, 1 patient with bronchial aspergillosis, 1 patient with pulmonary candidiasis and 3 patients with candidemia. One additional patient with pulmonary aspergillosis received three instillations of 20 mg of MCZ into the thoracic cavity. The clinical effects were excellent in 1, good in 4 and poor in 3 patients. The efficacy rate was 100% in 5 cases with respiratory fungal infections but 3 cases with candidemia did not respond well to the treatment. Four strains each of Aspergillus sp. and Candida sp. were identified as causative organisms. Seven of the 8 strains were eradicated by administration of MCZ. Side effects observed were irritation and heat in a leg in 1 patient, hyperlipoidemia in 2 patients and eosinophilia in 1 patient. The adverse reactions disappeared after the completion of the therapy. From the above results, we conclude that MCZ is one of the most useful antifungal agents for parenteral use as a first choice on deep-seated fungal infections in the respiratory tract.
我们评估了一种新的肠胃外使用的抗真菌药物咪康唑(MCZ,氟利汀注射液)对呼吸道系统深部真菌感染的治疗效果。对7例患者静脉注射每日剂量为400 - 1800毫克的MCZ,疗程为12 - 38天(平均:23.4天):2例肺曲霉病患者,1例支气管曲霉病患者,1例肺念珠菌病患者和3例念珠菌血症患者。另外1例肺曲霉病患者接受了3次每次20毫克的MCZ胸腔内注入。临床效果为优1例,良4例,差3例。5例呼吸道真菌感染患者的有效率为100%,但3例念珠菌血症患者对治疗反应不佳。分别鉴定出4株曲霉属和4株念珠菌属菌株为致病微生物。8株菌株中的7株通过MCZ给药被根除。观察到的副作用为1例患者腿部有刺激感和发热,2例患者出现高脂血症,1例患者出现嗜酸性粒细胞增多。治疗结束后不良反应消失。从上述结果来看,我们得出结论,MCZ是肠胃外使用的最有用的抗真菌药物之一,可作为呼吸道深部真菌感染的首选药物。