Alvarez Alvarez M E, Sánchez-Sousa A, Baquero F
Department of Microbiology, Mycology Unit, Ramón y Cajal Hospital, Madrid, Spain.
Rev Esp Quimioter. 1998 Dec;11(4):295-315.
The incidence of oropharyngeal candidiasis is growing. The species of the genus Candida are extremely frequent among human colonizers. The changes in the yeast-human interaction by aging, debilitating, and immunosuppressive diseases, and the more aggressive medical interventions can explain this phenomenon. Antifungals are used both in prophylaxis and therapy, but the number of available agents remains scarce. Acquired resistance to the more commonly used antifungal agents, the azole compounds, is also an increasing threat, Policies for antifungal use should be established in order to maintain the therapeutic possibilities of the current compounds, The widespread use of systemic azoles, agents useful in deep mycosis, may increasingly exert a selective power for resistant variants. Superficial infections, such as oropharyngeal candidiasis, can be successfully controlled by nystatin, a classic polyene, which is very well tolerated and has very low rates of resistance. This review on the importance of oropharyngeal candidiasis emphasizes this therapeutic possibility, and is complemented by in vitro studies documenting the excellent activity of nystatin on both azole-susceptible and resistant strains.
口咽念珠菌病的发病率正在上升。念珠菌属菌种在人类定植菌中极为常见。衰老、身体虚弱、免疫抑制性疾病以及更激进的医疗干预导致的酵母与人类相互作用的变化可以解释这一现象。抗真菌药物用于预防和治疗，但可用药物的数量仍然稀少。对更常用的抗真菌药物唑类化合物产生获得性耐药性也是一个日益严重的威胁。应制定抗真菌药物使用政策，以维持现有化合物的治疗可能性。全身用唑类药物（对深部真菌病有用）的广泛使用可能会越来越多地对耐药变体产生选择作用。浅表感染，如口咽念珠菌病，可用制霉菌素成功控制，制霉菌素是一种经典的多烯类药物，耐受性良好，耐药率极低。这篇关于口咽念珠菌病重要性的综述强调了这种治疗可能性，体外研究证明制霉菌素对唑类敏感和耐药菌株均具有出色活性，对该综述起到了补充作用。
