在医院附属门诊输液中心，使用每周三次的脂质体两性霉素B成功逐步减量治疗肺组织胞浆菌病：一例报告
Successful stepdown treatment of pulmonary histoplasmosis with thrice-weekly liposomal amphotericin B in a hospital-associated, outpatient infusion centre: A case report.
作者信息
Lewis P O, Khan I, Patel P
机构信息
Department of Pharmacy, Johnson City Medical Center, Johnson City, TN, USA.
Division of Infectious Diseases, Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA.
出版信息
J Clin Pharm Ther. 2018 Apr;43(2):269-272. doi: 10.1111/jcpt.12609. Epub 2017 Aug 14.
WHAT IS KNOWN AND OBJECTIVE
Amphotericin is the preferred treatment for pulmonary histoplasmosis during pregnancy. The long half-life of amphotericin supports less than daily administration.
CASE SUMMARY
A 28-year-old pregnant woman diagnosed with recurrent pulmonary histoplasmosis was initiated on liposomal amphotericin 250 mg (4 mg/kg) intravenously daily. After 2 weeks, the patient was discharged and successfully received 250 mg thrice weekly at a hospital-associated outpatient infusion centre. After 6 weeks of outpatient treatment, a chest X-ray demonstrated no remaining disease and therapy was discontinued.
WHAT IS NEW AND CONCLUSION
Administration of thrice-weekly liposomal amphotericin in a hospital-associated, outpatient infusion centre may be a promising option for stepdown treatment in patients unable to take itraconazole.
已知信息与目的
两性霉素是孕期肺组织胞浆菌病的首选治疗药物。两性霉素半衰期长，因此无需每日给药。
病例摘要
一名28岁的孕妇被诊断为复发性肺组织胞浆菌病，开始每日静脉注射250毫克（4毫克/千克）脂质体两性霉素。两周后，患者出院，并在医院附属的门诊输液中心成功接受每周三次250毫克的治疗。门诊治疗6周后，胸部X光显示无残留病灶，治疗停止。
新发现与结论
对于无法服用伊曲康唑的患者，在医院附属的门诊输液中心每周三次给予脂质体两性霉素可能是一种有前景的降阶梯治疗选择。
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