Stevens D A
Infection. 1987 Mar-Apr;15(2):87-92. doi: 10.1007/BF01650203.
The field of antifungal chemotherapy is undergoing rapid change at present, with an accelerating pace of introduction of new agents. The problems at present include the need for more effective agents, particularly with novel modes of action. Fungal infection must be considered more frequently in differential diagnosis, and methods developed for early diagnosis. The literature must be improved, with more precise terms. Trials comparing agents are needed, as are studies directed at determining the appropriate length of therapy. In vitro susceptibility testing must be standardized, and clinical correlations examined. Particular problem areas in current therapy are deep candida infections, zygomycotic infections, fungal endocarditis and meningitis, cryptococcosis in AIDS patients, and ocular infections with Fusarium species. Immunomodulating or "pro-host" drugs present an as yet unexplored avenue for clinical therapy. Regimes to prevent fungal infection need improvement. Until the needed advances occur, we must be resourceful in minimizing the toxicity of the agents presently available.
目前，抗真菌化疗领域正在迅速变革，新药物的推出速度不断加快。当前存在的问题包括需要更有效的药物，特别是具有新型作用模式的药物。在鉴别诊断中必须更频繁地考虑真菌感染，并开发早期诊断方法。必须改进文献，使用更精确的术语。需要进行比较药物的试验，也需要开展旨在确定适当治疗时长的研究。体外药敏试验必须标准化，并检验其与临床的相关性。当前治疗中特别棘手的领域包括深部念珠菌感染、接合菌感染、真菌性心内膜炎和脑膜炎、艾滋病患者的隐球菌病以及镰刀菌属引起的眼部感染。免疫调节或“亲宿主”药物为临床治疗提供了一条尚未探索的途径。预防真菌感染的方案需要改进。在取得所需进展之前，我们必须足智多谋，尽量降低现有药物的毒性。
