当前及新出现的唑类抗真菌药物。
Current and emerging azole antifungal agents.
作者信息
Sheehan D J, Hitchcock C A, Sibley C M
机构信息
Pfizer Pharmaceuticals Group, Pfizer Inc., New York, New York 10017-5755, USA.
出版信息
Clin Microbiol Rev. 1999 Jan;12(1):40-79. doi: 10.1128/CMR.12.1.40.
Major developments in research into the azole class of antifungal agents during the 1990s have provided expanded options for the treatment of many opportunistic and endemic fungal infections. Fluconazole and itraconazole have proved to be safer than both amphotericin B and ketoconazole. Despite these advances, serious fungal infections remain difficult to treat, and resistance to the available drugs is emerging. This review describes present and future uses of the currently available azole antifungal agents in the treatment of systemic and superficial fungal infections and provides a brief overview of the current status of in vitro susceptibility testing and the growing problem of clinical resistance to the azoles. Use of the currently available azoles in combination with other antifungal agents with different mechanisms of action is likely to provide enhanced efficacy. Detailed information on some of the second-generation triazoles being developed to provide extended coverage of opportunistic, endemic, and emerging fungal pathogens, as well as those in which resistance to older agents is becoming problematic, is provided.
20世纪90年代，唑类抗真菌药物的研究取得了重大进展，为许多机会性和地方性真菌感染的治疗提供了更多选择。事实证明，氟康唑和伊曲康唑比两性霉素B和酮康唑都更安全。尽管有这些进展，但严重的真菌感染仍然难以治疗，而且对现有药物的耐药性正在出现。这篇综述描述了目前可用的唑类抗真菌药物在治疗全身性和浅表性真菌感染方面的现状和未来用途，并简要概述了体外药敏试验的现状以及唑类药物临床耐药性日益严重的问题。将目前可用的唑类药物与其他具有不同作用机制的抗真菌药物联合使用可能会提高疗效。文中还提供了一些正在研发的第二代三唑类药物的详细信息，这些药物旨在扩大对机会性、地方性和新出现的真菌病原体的覆盖范围，以及对旧有药物产生耐药性问题的病原体。
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