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本文引用的文献

1
Isavuconazole Diffusion in Infected Human Brain.伊曲康唑在感染人脑中的扩散。
Antimicrob Agents Chemother. 2019 Sep 23;63(10). doi: 10.1128/AAC.02474-18. Print 2019 Oct.
2
Tissue Distribution and Penetration of Isavuconazole at the Site of Infection in Experimental Invasive Aspergillosis in Mice with Underlying Chronic Granulomatous Disease.组织分布和伏立康唑在患有慢性肉芽肿病的实验性侵袭性曲霉菌病小鼠感染部位的渗透。
Antimicrob Agents Chemother. 2019 May 24;63(6). doi: 10.1128/AAC.00524-19. Print 2019 Jun.
3
EUCAST Susceptibility Testing of Isavuconazole: MIC Data for Contemporary Clinical Mold and Yeast Isolates.EUCAST 伏立康唑药敏试验：当代临床霉菌和酵母分离株的 MIC 数据。
Antimicrob Agents Chemother. 2019 May 24;63(6). doi: 10.1128/AAC.00073-19. Print 2019 Jun.
4
Isavuconazole Versus Caspofungin in the Treatment of Candidemia and Other Invasive Candida Infections: The ACTIVE Trial.伊曲康唑与卡泊芬净治疗念珠菌血症和其他侵袭性念珠菌感染：ACTIVE 试验。
Clin Infect Dis. 2019 May 30;68(12):1981-1989. doi: 10.1093/cid/ciy827.
5
Isavuconazole: A new broad-spectrum azole. Part 2: pharmacokinetics and clinical activity.伊曲康唑：一种新型广谱唑类药物。第 2 部分：药代动力学和临床活性。
J Mycol Med. 2018 Mar;28(1):15-22. doi: 10.1016/j.mycmed.2018.02.002. Epub 2018 Mar 16.
6
Isavuconazole: A new broad-spectrum azole. Part 1: In vitro activity.伊曲康唑：一种新型广谱唑类药物。第 1 部分：体外活性。
J Mycol Med. 2018 Mar;28(1):8-14. doi: 10.1016/j.mycmed.2018.02.005. Epub 2018 Mar 11.
7
Pharmacokinetics of antifungal drugs: practical implications for optimized treatment of patients.抗真菌药物的药代动力学：优化患者治疗的实际意义。
Infection. 2017 Dec;45(6):737-779. doi: 10.1007/s15010-017-1042-z. Epub 2017 Jul 12.
8
Pharmacokinetic study of anidulafungin in ICU patients with intra-abdominal candidiasis.阿尼芬净在腹腔内念珠菌病重症监护病房患者中的药代动力学研究。
J Antimicrob Chemother. 2017 May 1;72(5):1429-1432. doi: 10.1093/jac/dkw568.
9
Fungal Peritonitis: Underestimated Disease in Critically Ill Patients with Liver Cirrhosis and Spontaneous Peritonitis.真菌性腹膜炎：肝硬化合并自发性腹膜炎重症患者中被低估的疾病
PLoS One. 2016 Jul 8;11(7):e0158389. doi: 10.1371/journal.pone.0158389. eCollection 2016.
10
Isavuconazole versus voriconazole for primary treatment of invasive mould disease caused by Aspergillus and other filamentous fungi (SECURE): a phase 3, randomised-controlled, non-inferiority trial.伊曲康唑与伏立康唑治疗曲霉菌和其他丝状真菌所致侵袭性霉菌病的初步治疗（SECURE）：一项 3 期随机对照非劣效性试验。
Lancet. 2016 Feb 20;387(10020):760-9. doi: 10.1016/S0140-6736(15)01159-9. Epub 2015 Dec 10.

危重患者腹水中的艾沙康唑渗透情况

Penetration of Isavuconazole in Ascites Fluid of Critically Ill Patients.

作者信息

Lahmer Tobias, Batres Baires Gonzalo, Schmid Roland M, Wiessner Johannes R, Ulrich Jörg, Reichert Maximilian, Huber Wolfgang, Sörgel Fritz, Kinzig Martina, Rasch Sebastian, Mayr Ulrich

机构信息

Klinik und Poliklinik für Innere Medizin II, Klinikum rechts der Isar der Technischen Universität München, Ismaningerstrasse 22, 81675 Munich, Germany.

IBMP-Institute for Biomedical and Pharmaceutical Research, Paul-Ehrlich-Straße 19, 90562 Nürnberg-Heroldsberg, Germany.

出版信息

J Fungi (Basel). 2021 May 11;7(5):376. doi: 10.3390/jof7050376.

DOI:10.3390/jof7050376
PMID:34064945
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8150505/
Abstract

Fungal peritonitis is a life-threatening condition which is not only difficult to diagnose, but also to treat. Following recent guidelines, echinocandins and azoles are the recommended antimycotics for the management of intra-abdominal spp. infections, with a favor for echinocandins in critically ill patients. However, the new extended spectrum triazole isavuconazole also has a broad spectrum against spp. Data on its target-site penetration are sparse. Therefore, we assessed isavuconazole concentrations and penetration ratios in ascites fluid of critically ill patients. Obtaining of Isavuconazole plasma and ascites fluid levels as well penetration ratios using paracentesis in critically ill patients. Isavuconazole concentrations were quantified in human plasma and ascites by a liquid chromatography/tandem mass spectrometry (LC-MS/MS) method. Isavuconazole concentrations in plasma and ascites fluid were measured in sixteen critically ill patients. Isavuconazol levels in ascites fluid (1.06 µg/mL) were lower than plasma levels (3.08 µg/mL). Penetration ratio was 36%. In two out of sixteen patients, spp., in detail C. glabrata and C. tropicalis, could be isolated. Cmax/MIC Ratio in plasma of 560 for C. glabrata and 2166 for C. tropicalis could be observed. Following our results, isavuconazole penetrates into ascites. Successful treatment in spp. peritonitis depends on pathogen susceptibility.

摘要

真菌性腹膜炎是一种危及生命的疾病，不仅难以诊断，而且难以治疗。根据最新指南，棘白菌素和唑类是推荐用于治疗腹腔内感染的抗真菌药物，在重症患者中更倾向于使用棘白菌素。然而，新型广谱三唑类药物艾沙康唑对也有广泛的抗菌谱。关于其靶位渗透的数据很少。因此，我们评估了重症患者腹水中艾沙康唑的浓度和渗透比。通过腹腔穿刺术获取重症患者的艾沙康唑血浆和腹水水平以及渗透比。采用液相色谱/串联质谱（LC-MS/MS）法对人血浆和腹水中的艾沙康唑浓度进行定量。测定了16例重症患者血浆和腹水中的艾沙康唑浓度。腹水中的艾沙康唑水平（1.06μg/mL）低于血浆水平（3.08μg/mL）。渗透比为36%。在16例患者中的2例中分离出，具体为光滑念珠菌和热带念珠菌。光滑念珠菌血浆中的Cmax/MIC比值为560，热带念珠菌为2166。根据我们的结果，艾沙康唑可渗透到腹水中。治疗性腹膜炎的成功取决于病原体的敏感性。