Epstein J B, Polsky B
Department of Dentistry, Vancouver Hospital & Health Sciences Center, British Columbia.
Clin Ther. 1998 Jan-Feb;20(1):40-57. doi: 10.1016/s0149-2918(98)80033-7.
With the increased use of antibiotics and immunosuppressive agents, oropharyngeal candidiasis is becoming more common. This infection is also associated with such advances in medical management as chemotherapy and organ transplantation and with human immunodeficiency virus infection. Various topical and systemic agents are available to treat patients with candidiasis, but optimal management can be elusive. Treatment of uncomplicated oropharyngeal candidiasis in the immunocompetent patient involves selecting a particular formulation of a topical medication based on oral conditions, length of contact time, and taste, texture, and cost of the medication. Treatment of severe oropharyngeal candidiasis, particularly in patients with a compromised immune system, is often more difficult, and relapses are common. Reports of resistance to systemic agents, particularly in patients needing recurrent therapy, are increasing. Amphotericin B, long used as an intravenous agent, is now available as an oral suspension that may offer therapeutic benefits comparable to those of systemic therapy without the toxicity associated with systemic absorption.
随着抗生素和免疫抑制剂使用的增加，口腔念珠菌病越来越常见。这种感染还与化疗、器官移植等医学治疗进展以及人类免疫缺陷病毒感染有关。有多种局部和全身用药可用于治疗念珠菌病患者，但最佳治疗方案可能难以确定。免疫功能正常患者的单纯性口腔念珠菌病治疗包括根据口腔状况、接触时间长短以及药物的味道、质地和成本选择特定剂型的局部用药。严重口腔念珠菌病的治疗，尤其是免疫系统受损患者的治疗，通常更为困难，且复发很常见。对全身用药耐药的报道越来越多，尤其是在需要反复治疗的患者中。长期用作静脉用药的两性霉素B现在有口服混悬液剂型，其治疗效果可能与全身治疗相当，且无全身吸收相关的毒性。
