Lumbreras C, Cuervas-Mons V, Jara P, del Palacio A, Turrión V S, Barrios C, Moreno E, Noriega A R, Paya C V
Microbiology and Surgery Department, Hospital Doce de Octubre, Universidad Complutense de Madrid, Spain.
J Infect Dis. 1996 Sep;174(3):583-8. doi: 10.1093/infdis/174.3.583.
A prospective, randomized, multicenter study addressed the safety and efficacy of fluconazole therapy in 143 liver transplant patients. Seventy-six patients received daily oral fluconazole (100 mg), and 67 received nystatin (4 X 10(6) U) during the first 28 days after transplantation. Candida colonization occurred in 25% and 53% of patients in the fluconazole and nystatin groups, respectively (P = .04), and 13% and 34% of patients in the respective groups had Candida infections (P = .022). Of these patients, 10.5% in the fluconazole group and 25.3% in the nystatin group had superficial candidal infections (P = .024). Invasive candidiasis developed in 2 patients in the fluconazole group (2.6%) and 6 in the nystatin group (9.0%) (P = .12). There was no increased hepatotoxicity, cyclosporine interaction, or emergence of clinically relevant resistant Candida strains attributable to fluconazole. Thus, oral fluconazole (100 mg) is safe and reduces Candida colonization and infection after liver transplantation.
一项前瞻性、随机、多中心研究探讨了氟康唑治疗143例肝移植患者的安全性和有效性。76例患者在移植后的前28天接受每日口服氟康唑（100毫克），67例患者接受制霉菌素（4×10⁶单位）。氟康唑组和制霉菌素组念珠菌定植率分别为25%和53%（P = 0.04），相应组中念珠菌感染率分别为13%和34%（P = 0.022）。在这些患者中，氟康唑组10.5%和制霉菌素组25.3%发生浅表念珠菌感染（P = 0.024）。氟康唑组有2例患者（2.6%）发生侵袭性念珠菌病，制霉菌素组有6例患者（9.0%）发生侵袭性念珠菌病（P = 0.12）。未发现因氟康唑导致肝毒性增加、环孢素相互作用或出现临床相关的耐药念珠菌菌株。因此，口服氟康唑（100毫克）是安全的，可减少肝移植后念珠菌的定植和感染。
