Anaissie E J, Darouiche R O, Abi-Said D, Uzun O, Mera J, Gentry L O, Williams T, Kontoyiannis D P, Karl C L, Bodey G P
Department of Medical Specialties, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
Clin Infect Dis. 1996 Nov;23(5):964-72. doi: 10.1093/clinids/23.5.964.
We conducted a prospective, randomized, multicenter study comparing fluconazole and amphotericin B in the treatment of candidal infections. One hundred and sixty-four patients (60 of whom were neutropenic) with documented or presumed invasive candidiasis were assigned to treatment with either fluconazole (400 mg daily) or amphotericin B (25-50 mg daily; 0.67 mg/kg daily for neutropenic patients). Clinical response and survival rates were assessed at 48 hours, after 5 days, and at the end of therapy. Overall response rates to fluconazole and amphotericin B were similar (66% and 64%, respectively). There were no differences in response as related to site of infection, pathogen, time to defervescence, relapse, or survival rates between the groups. Adverse effects were more frequent with amphotericin B (35%) than with fluconazole (5%; P < .0001). The results of this study confirm that fluconazole is as effective as but better tolerated than amphotericin B in the treatment of candidal infections.
我们进行了一项前瞻性、随机、多中心研究，比较氟康唑和两性霉素B治疗念珠菌感染的效果。164例有记录或疑似侵袭性念珠菌病的患者（其中60例为中性粒细胞减少患者）被分配接受氟康唑（每日400毫克）或两性霉素B（每日25 - 50毫克；中性粒细胞减少患者每日0.67毫克/千克）治疗。在48小时、5天后以及治疗结束时评估临床反应和生存率。氟康唑和两性霉素B的总体反应率相似（分别为66%和64%）。两组在感染部位、病原体、退热时间、复发率或生存率方面的反应无差异。两性霉素B的不良反应（35%）比氟康唑（5%；P < .0001）更常见。本研究结果证实氟康唑在治疗念珠菌感染方面与两性霉素B效果相同，但耐受性更好。
