Bennet J E
Ann Intern Med. 1977 Mar;86(3):319-21. doi: 10.7326/0003-4819-86-3-319.
Flucytosine is a systemic antifungal drug that is readily absorbed from the gastrointestinal tract. The most clearly documented therapeutic effect has been in cryptococcosis, candidiasis, and chromomycosis. An important limitation of the use of flucytosine in all three diseases has been drug resistance arising during therapy. The addition of low-dose, intravenous amphotericin B to flucytosine therapy of cryptococcosis has appeared to decrease the frequency of secondary flucytosine resistance. In addition, the two drugs have an additive or slightly synergistic effect against flucytosine susceptible isolates of Cryptococcus and Candida. The combination is probably the treatment of choice in cryptococcal meningitis and offers promise in the therapy of systemic candidiasis and nonmeningeal cryptococcosis.
氟胞嘧啶是一种全身性抗真菌药物,可从胃肠道迅速吸收。最有明确记录的治疗效果见于隐球菌病、念珠菌病和着色芽生菌病。在这三种疾病中使用氟胞嘧啶的一个重要局限性是治疗期间出现耐药性。在隐球菌病的氟胞嘧啶治疗中添加低剂量静脉注射两性霉素B似乎可降低继发性氟胞嘧啶耐药的发生率。此外,这两种药物对氟胞嘧啶敏感的隐球菌和念珠菌分离株具有相加或轻微协同作用。该联合用药可能是隐球菌性脑膜炎的首选治疗方法,在系统性念珠菌病和非脑膜隐球菌病的治疗中也有前景。