侵袭性曲霉病联合抗真菌治疗再探讨。
Combination Antifungal Therapy for Invasive Aspergillosis Revisited.
作者信息
Panackal Anil A
机构信息
Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA; Division of Infectious Diseases, Department of Medicine, F. Hèbert School of Medicine, Uniformed Services University of the Health Sciences (USUHS).
出版信息
Med Mycol Open Access. 2016;2(2). doi: 10.21767/2471-8521.100012. Epub 2016 Apr 29.
Invasive aspergillosis (IA) causes significant morbidity and mortality among immunocompromised hosts. Combination therapy with mold-active triazoles and echinocandins has been used with the hope of improving outcomes over monotherapy, especially in the setting of refractory disease. Herein, I update our prior systematic review and meta-analysis on combination therapy for salvage IA in the context of the recently published randomized clinical trial of combination therapy for primary IA. Clinicians should consider combination antifungals for IA in refractory disease despite immune reconstitution when there are concerns for resistance or pharmacokinetic variability.
侵袭性曲霉病（IA）在免疫功能低下的宿主中会导致严重的发病率和死亡率。联合使用具有抗霉菌活性的三唑类药物和棘白菌素进行治疗，以期比单一疗法能改善治疗效果，尤其是在难治性疾病的情况下。在此，我根据最近发表的关于原发性IA联合治疗的随机临床试验，更新我们之前关于挽救性IA联合治疗的系统评价和荟萃分析。尽管免疫功能已恢复，但在存在耐药性或药代动力学变异性问题时，临床医生对于难治性疾病的IA应考虑联合使用抗真菌药物。
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