氟康唑与氟胞嘧啶联合治疗肺隐球菌病。

Combination therapy with fluconazole and flucytosine for pulmonary cryptococcosis.

作者信息

Yamamoto Y, Maesaki S, Kakeya H, Yanagihara K, Ohno H, Ogawa K, Hirakata Y, Tomono K, Tashiro T, Kohno S

机构信息

Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan.

出版信息

Chemotherapy. 1997 Nov-Dec;43(6):436-41. doi: 10.1159/000239603.

DOI:10.1159/000239603

PMID:9395858

Abstract

We investigated, in vitro, the combined effects of fluconazole (FLCZ) and flucytosine (5-FC) against different strains of Cryptococcus neoformans, and retrospectively analyzed the clinical efficacy of combination therapy of FLCZ and 5-FC in patients with pulmonary cryptococcosis. The minimum inhibitory concentrations (MICs) of antifungal agents and drug interaction were determined by the broth microdilution method and checkerboard titration. FLCZ and 5-FC showed synergistic activity against 8 (32%) of 25 strains of C. neoformans. The clinical efficacy of the 2 drugs when combined together was good in 9 (90%) patients and fair in 1 (10%) patient with pulmonary cryptococcosis. Renal dysfunction occurred in 1 patient. Our results suggest that a combination therapy using FLCZ and 5-FC is clinically useful in patients with pulmonary cryptococcosis who otherwise show a limited response to monotherapy.

摘要

我们在体外研究了氟康唑（FLCZ）和氟胞嘧啶（5-FC）对不同新型隐球菌菌株的联合作用，并回顾性分析了FLCZ和5-FC联合治疗肺隐球菌病患者的临床疗效。采用肉汤微量稀释法和棋盘滴定法测定抗真菌药物的最低抑菌浓度（MICs）和药物相互作用。FLCZ和5-FC对25株新型隐球菌中的8株（32%）显示出协同活性。联合使用这两种药物时，9例（90%）肺隐球菌病患者的临床疗效良好，1例（10%）患者疗效一般。1例患者出现肾功能障碍。我们的结果表明，对于单药治疗反应有限的肺隐球菌病患者，使用FLCZ和5-FC的联合治疗在临床上是有用的。