Centro Universitário Mauricio de Nassau Recife Brazil Centro Universitário Mauricio de Nassau, Recife, Brazil.
Universidade Federal de Pernambuco Centro de Biociências Recife Brazil Pós-graduação em Inovação Terapêutica (PPGIT), Centro de Biociências, Universidade Federal de Pernambuco, Recife, Brazil.
Braz J Cardiovasc Surg. 2020 Oct 1;35(5):789-796. doi: 10.21470/1678-9741-2019-0159.
Although it is the most common agent among the fungal causes of endocarditis, Candida albicans endocarditis is rare.
To evaluate the efficacy of amphotericin B in the treatment of C. albicans endocarditis beyond a systematic review.
Articles in English, Spanish and Portuguese, conducted in the following databases: MEDLINE, LILACS, IBECS and SciELO, in humans and published in the last 25 years.
Observational studies, clinical trials, and case series providing data on the amphotericin B use in patients with a C. albicans endocarditis diagnosis without age limitations.
From the initial search (n=79), 25 articles were fully evaluated, of which 19 were excluded for meeting one or more exclusion criteria, remaining five articles (two observational studies and three case series). Patients using amphotericin B demonstrated improvement in survival rates, and its main use was in association with the surgical method as well as with caspofungin association.
Literature lacks evidence to conclude about efficacy and safety of amphotericin B in the treatment of fungal endocarditis. Randomized clinical trials are necessary to provide better evidence on the subject.
虽然白色念珠菌是引起心内膜炎的最常见真菌病原体，但白色念珠菌心内膜炎却较为罕见。
评估两性霉素 B 在治疗白色念珠菌心内膜炎方面的疗效，这一评估超越了系统性综述。
检索了 25 年来在 MEDLINE、LILACS、IBECS 和 SciELO 等英文、西班牙文和葡萄牙文数据库中发表的人类观察性研究、临床试验和病例系列研究，未对纳入研究的年龄进行限制。
纳入了观察性研究、临床试验和病例系列研究，这些研究均提供了有关白色念珠菌心内膜炎患者使用两性霉素 B 的数据，而无年龄限制。
从最初的检索（n=79）中，有 25 篇文章进行了全面评估，其中 19 篇因符合一条或多条排除标准而被排除，最终纳入 5 篇文章（2 篇观察性研究和 3 篇病例系列研究）。使用两性霉素 B 的患者生存率有所提高，其主要用途是与手术方法联合使用，也与卡泊芬净联合使用。
文献中缺乏关于两性霉素 B 治疗真菌性心内膜炎的疗效和安全性的结论性证据。需要开展随机临床试验，以提供关于该主题的更好证据。
