Clark A B, Lobo B L, Gelfand M S
Department of Pharmacy, University of Tennessee, USA.
Ann Pharmacother. 1996 Dec;30(12):1408-10. doi: 10.1177/106002809603001209.
To describe a patient with cryptococcal meningitis treated with the combination of amphotericin B and fluconazole.
A 41-year-old woman with cryptococcal meningitis who was not infected with HIV was treated with a combination of amphotericin B and fluconazole because she did not respond to amphotericin B alone and could not tolerate amphotericin B with flucytosine. She improved clinically, but it is unclear whether the combination was beneficial.
Standard therapy for cryptococcal meningitis is amphotericin B with or without flucytosine. Fluconazole is an alternative therapy, but its efficacy has not been documented in the patient population not infected with HIV. Theoretically, the combination of amphotericin B and fluconazole is antagonistic, but in vitro and in vivo data suggest that antagonism may not occur. The combination of amphotericin B and fluconazole in cryptococcal meningitis has not been evaluated in clinical trials, and its use is not recommended.
A patient with cryptococcal meningitis was treated with the combination of amphotericin B and fluconazole because of a poor response to amphotericin B monotherapy and intolerance to flucytosine. It is unclear whether her clinical response was a result of the combination.
描述一名接受两性霉素B和氟康唑联合治疗的隐球菌性脑膜炎患者。
一名41岁未感染HIV的隐球菌性脑膜炎女性患者，因对单用两性霉素B无反应且无法耐受两性霉素B与氟胞嘧啶联合治疗，故接受两性霉素B和氟康唑联合治疗。她的临床症状有所改善，但联合治疗是否有益尚不清楚。
隐球菌性脑膜炎的标准治疗是使用两性霉素B，可加用或不加用氟胞嘧啶。氟康唑是一种替代疗法，但其在未感染HIV的患者群体中的疗效尚未得到证实。理论上，两性霉素B和氟康唑联合使用具有拮抗作用，但体外和体内数据表明可能不会出现拮抗作用。两性霉素B和氟康唑联合治疗隐球菌性脑膜炎尚未在临床试验中进行评估，不建议使用。
一名隐球菌性脑膜炎患者因对两性霉素B单一疗法反应不佳且对氟胞嘧啶不耐受，接受了两性霉素B和氟康唑联合治疗。尚不清楚她的临床反应是否是联合治疗的结果。
