Sipsas Nikolaos V, Gamaletsou Maria N, Anastasopoulou Amalia, Kontoyiannis Dimitrios P
Pathophysiology Department, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, 115 27 Athens, Greece.
Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA.
J Fungi (Basel). 2018 Jul 31;4(3):90. doi: 10.3390/jof4030090.
Despite the recent introduction of mold-active agents (posaconazole and isavuconazole), in addition to amphotericin B products, to our armamentarium against mucormycosis, many uncertainties remain for the management of this uncommon opportunistic infection, as there are no data from prospective randomized clinical trials to guide therapy. In this mini-review, we present the current status of treatment options. In view of the heterogeneity of the disease (different types of affected hosts, sites of infection, and infecting Mucorales), mucormycosis management requires an individualized management plan that takes into account the net state of immunosuppression of the host, including comorbidities, certainty of diagnosis, site of infection, and antifungal pharmacological properties.
尽管最近除两性霉素B类产品外,又有新型抗霉菌药物(泊沙康唑和艾沙康唑)加入我们治疗毛霉菌病的药物储备,但由于缺乏前瞻性随机临床试验数据来指导治疗,对于这种罕见的机会性感染的管理仍存在许多不确定性。在本综述中,我们介绍了当前的治疗选择现状。鉴于该疾病的异质性(受影响宿主的类型、感染部位以及感染的毛霉目真菌不同),毛霉菌病的管理需要一个个性化的管理方案,该方案要考虑宿主免疫抑制的总体状况,包括合并症、诊断的确定性、感染部位以及抗真菌药物的药理学特性。