Eichel M, Just-Nübling G, Helm E B, Stille W
Abteilung Infektiologie, Johann-Wolfgang-Goethe-Universität Frankfurt am Main, BR Deutschland.
Mycoses. 1996;39 Suppl 1:102-6. doi: 10.1111/j.1439-0507.1996.tb00514.x.
Forty AIDS patients suffering from fluconazole-resistant oropharyngeal candidosis were treated with oral itraconazole solution (200-800 mg/day). In 39/49 patients the disease could be initially cured or significantly improved. In contrast to the good clinical results, however, only in six patients a yeast count reduction was observed, and in four patients unchanged high yeast counts persisted. The main pathogen was C. albicans. Even in longtime treatment itraconazole solution was well tolerated. In two patients only the therapy had to be stopped due to the increase of transaminases. Considerable individual deviations in serum concentrations of itraconazole or hydroxy-itraconazole, respectively, were observed which correlated only to a minor degree with clinical and mycological results. Application of itraconazole in a soluble preparation caused an increase in efficacy due to simultaneous local and systemic action. In the case of resistance to fluconazole the itraconazole solution is a valuable alternative to the administration of amphotericin B which is rich in adverse reactions.
40例患有氟康唑耐药性口咽念珠菌病的艾滋病患者接受口服伊曲康唑溶液治疗（200 - 800毫克/天）。在49例患者中的39例，疾病最初得到治愈或显著改善。然而，与良好的临床结果形成对比的是，仅在6例患者中观察到酵母菌数量减少，4例患者中酵母菌数量持续处于高水平且无变化。主要病原体为白色念珠菌。即使在长期治疗中，伊曲康唑溶液的耐受性也良好。仅在2例患者中，由于转氨酶升高不得不停止治疗。分别观察到伊曲康唑或羟基伊曲康唑血清浓度存在相当大的个体差异，这些差异与临床和真菌学结果仅存在较小程度的相关性。伊曲康唑以可溶性制剂形式应用，由于同时具有局部和全身作用，导致疗效增加。在对氟康唑耐药的情况下，伊曲康唑溶液是不良反应较多的两性霉素B给药的一种有价值的替代药物。
