Donowitz L G, Hendley J O
Department of Pediatrics, University of Virginia Health Sciences Center, Charlottesville 22908, USA.
Pediatrics. 1995 Jun;95(6):888-91.
To determine the efficacy of short-course (7 to 14 days of therapy after the last positive blood culture) amphotericin B therapy for candidemia in children.
Case series.
Tertiary care university medical center in Virginia.
Thirty patients younger than 17 years of age who had candidemia between 1983 and 1990.
The charts of 30 children with 31 episodes of candidemia were retrospectively reviewed for patient data, dates of positive and negative cultures for Candida from blood and other sites, dates of removal of the intravascular catheters, duration and dosage of amphotericin B administration, and outcome. Eight patients had persistent candidemia and died. Five patients were treated not in accordance with the short-course recommendations. Two had relapses; 1 was cured with catheter removal alone, and 2 were successfully treated with 26 and 30 days of amphotericin B therapy. Eighteen episodes (two episodes in 1 patient) of candidemia were cured using 7 to 14 days of amphotericin B therapy after the last positive blood culture.
Once the bloodstream is sterilized, and there is no other evidence of invasive fungal disease, 7 to 14 additional days of amphotericin B at a dose of 0.5 mg/kg per day seems adequate for treatment of candidemia in children.
确定短疗程（最后一次血培养阳性后治疗7至14天）两性霉素B治疗儿童念珠菌血症的疗效。
病例系列。
弗吉尼亚州的三级护理大学医学中心。
1983年至1990年间患有念珠菌血症的30名17岁以下儿童。
回顾性分析30例患有31次念珠菌血症儿童的病历，以获取患者数据、血液及其他部位念珠菌培养阳性和阴性的日期、血管内导管拔除日期、两性霉素B的给药持续时间和剂量以及治疗结果。8例患者念珠菌血症持续并死亡。5例患者未按照短疗程建议进行治疗。2例复发；1例仅通过拔除导管治愈，2例分别接受26天和30天的两性霉素B治疗后成功治愈。18次（1例患者出现2次）念珠菌血症在最后一次血培养阳性后使用7至14天的两性霉素B治疗得以治愈。
一旦血流被除菌，且无侵袭性真菌病的其他证据，每天以0.5mg/kg的剂量额外使用7至14天的两性霉素B似乎足以治疗儿童念珠菌血症。
