de Vries-Hospers H G, Mulder N H, Sleijfer D T, van Saene H K
Infection. 1982;10(2):71-5. doi: 10.1007/BF01816727.
A retrospective evaluation was made on the value of amphotericin B lozenges in the selective elimination of yeasts from the oropharynx. Four different groups of severely granulocytopenic patients were studied. All 77 patients received amphotericin B orally as a suspension or as tablets. Four amphotericin B lozenges were also administered daily for topical antimycotic decontamination of the oropharynx. This was done in the presence of colonization-resistance decreasing factors such as a nasogastric tube (Group I, 19 patients) or mucosal damage (Group III, 25 patients) and in patients with four or more consecutive throat swab cultures with yeasts (Group IV, 11 patients). The 22 patients in Group II did not receive lozenges. The addition of lozenges resulted in a decrease in the mean "growth density" of Candida cells in the oropharynx. This reduction was significant in Group III (p less than 0.01) and Group IV (p less than 0.02) and became evident during the first week of treatment. In patients with a nasogastric tube, however, 51.8% of the throat swab cultures revealed yeasts. Increasing the dose of the lozenges might improve the results in these patients. Topical treatment of the oropharynx with amphotericin B lozenges is advocated for patients who are susceptible to Candida infections.
对两性霉素B含片在选择性清除口咽部酵母菌方面的价值进行了回顾性评估。研究了四组不同的严重粒细胞减少症患者。所有77例患者均口服两性霉素B混悬液或片剂。还每天给予4片两性霉素B含片，对口咽部进行局部抗真菌去污。在存在如鼻胃管（I组，19例患者）或黏膜损伤（III组，25例患者）等降低定植抵抗力因素的患者以及连续4次或更多次咽喉拭子培养出酵母菌的患者（IV组，11例患者）中进行了此项操作。II组的22例患者未接受含片治疗。添加含片导致口咽部念珠菌细胞的平均“生长密度”降低。这种降低在III组（p<0.01）和IV组（p<0.02）中具有显著性，并且在治疗的第一周就很明显。然而，在有鼻胃管的患者中，51.8%的咽喉拭子培养显示有酵母菌。增加含片剂量可能会改善这些患者的治疗效果。对于易患念珠菌感染的患者，提倡用两性霉素B含片对口咽部进行局部治疗。
