Amphotericin B and coccidioidomycosis
Amphotericin B and coccidioidomycosis
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DOI：
10.1196/annals.1406.019
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发表时间：
2007-01-01
期刊：
影响因子：
--
通讯作者：
Einstein, Hans E.
中科院分区：
文献类型：
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作者：
Johnson, Royce H.;Einstein, Hans E.
在20世纪50年代之前，球孢子菌病没有有效的治疗方法。球孢子菌素B的出现开创了球孢子菌病的治疗时代。在此之前，阿替霉素B及其脂质同系物一直被视为治疗严重肺和播散性球孢子菌病的“金标准”。在过去的三十年中，唑类和后来的三唑类的可用性使阿替霉素降级为救援模式，主要用于广泛传播的病例、唑类不耐受或有唑类禁忌症时，如妊娠。在脑膜炎中，鞘内注射庆大霉素B仍然经常被一些临床医生单独使用或与三唑一起使用。较新的脂质制剂虽然更昂贵，但毒性显著降低，特别是肾病。
Prior to the 1950s no effective therapy for coccidioidomycosis existed. The advent of amphotericin B ushered in the therapeutic era for coccidioidomycosis. Until this time amphotericin B and its lipid congeners have been regarded as the "gold standard" of therapy for severe pulmonary and disseminated coccidioidomycosis. The availability of azoles and later triazoles for the past three decades have relegated the amphotericins into a rescue mode, used mainly in widely disseminated cases, azole intolerance, or when there are contraindications to Azoles, such as pregnancy. In meningitis the intrathecal use of amphotericin B is still used frequently by some clinicians alone or with a triazole. The newer lipid preparations, while more expensive, have significantly reduced toxicity, particularly nephropathy.