TREATMENT OF EXPERIMENTAL CRYPTOCOCCAL MENINGITIS WITH AMPHOTERICIN-B, 5-FLUOROCYTOSINE, AND KETOCONAZOLE
TREATMENT OF EXPERIMENTAL CRYPTOCOCCAL MENINGITIS WITH AMPHOTERICIN-B, 5-FLUOROCYTOSINE, AND KETOCONAZOLE
复制标题
DOI：
10.1093/infdis/146.3.429
复制
发表时间：
1982-01-01
影响因子：
6.4
通讯作者：
DURACK, DT
中科院分区：
文献类型：
--
作者：
PERFECT, JR;DURACK, DT
本文比较了酮康唑、阿替霉素B、5-氟胞嘧啶及其联合用药对激素治疗兔慢性隐球菌性脑膜炎的疗效。用单一药物治疗患有脑膜炎的兔后2小时，5-氟胞嘧啶的平均CSF浓度为4.4 μ g/ml，阿替霉素B的平均CSF浓度< 0.3 μ g/ml，酮康唑的平均CSF浓度范围为< 0.02-0.8 μ g/ml。连续定量培养结果表明，单药方案中以阿朴霉素B最佳。当与氟胞嘧啶或治疗剂量的阿替霉素B联合使用2周时，酮康唑几乎没有或没有累加效应。在为期2周的治疗方案中，酮康唑联合阿替霉素B至少与阿替霉素B联合5-氟胞嘧啶一样有效。在亚治疗剂量的阿替霉素B中加入酮康唑可显著增加对CSF中隐球菌的杀灭作用。
Ketoconazole, amphotericin B, 5-fluorocytosine and combinations of these drugs were compared as therapy for chronic cryptococcal meningitis in steroid-treated rabbits. Two h after treatment of rabbits with meningitis with single drugs the mean CSF concentration of 5-fluorocytosine was 4.4 .mu.g/ml, that of amphotericin B was < 0.3 .mu.g/ml and that of ketoconazole ranged from < 0.02-0.8 .mu.g/ml. Serial quantitative cultures indicated that amphotericin B was the best single-drug regimen. Ketoconazole provided little or no additive effect when used in combination with fluorocytosine or therapeutic doses of amphotericin B for 2 wk. The combination of ketoconazole plus amphotericin B was at least as effective as amphotericin B plus 5-fluorocytosine over a 2-wk treatment regimen. The addition of ketoconazole to a subtherapeutic dose of amphotericin B significantly increased the killing of cryptococci in CSF.