Treatment of cerebral Aspergillosis with itraconazole: do high doses improve the prognosis?
Treatment of cerebral Aspergillosis with itraconazole: do high doses improve the prognosis?
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伊曲康唑治疗脑曲霉病：高剂量能否改善预后？
DOI：
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发表时间：
1995
影响因子：
11.8
通讯作者：
J. Garau
中科院分区：
文献类型：
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作者：
C. Sánchez;E. Mauri;David Dalman;S. Quintana;A. Aparicio;J. Garau
我们描述了一位患有慢性哮喘的 72 岁女性，她在接受皮质类固醇治疗后出现了由烟曲霉引起的脑脓肿。高剂量伊曲康唑治疗（800 mg/d，持续 5 个月，随后 400 mg/d，持续 4.5 个月）导致所有病变完全消退。药物的血清浓度范围为2微克/mL至30微克/mL。对接受伊曲康唑治疗的 20 例脑曲霉病病例进行回顾发现，接受高剂量（成人 800 mg/d）药物的 4 名患者中有 3 名反应良好，而接受 400 mg/d 剂量的 16 名患者中只有 2 名治愈。对于常规治疗无效的脑曲霉病高危患者，使用大剂量伊曲康唑似乎是合理的。
We describe a 72-year-old woman with chronic asthma who presented with cerebral abscesses due to Aspergillus fumigatus after she received treatment with corticosteroids. Therapy with high-dose itraconazole (800 mg/d for 5 months, followed by 400 mg/d for an additional 4.5 months) resulted in complete resolution of all lesions. Serum concentrations of the drug ranged from 2 micrograms/mL to 30 micrograms/mL. Review of 20 cases of cerebral aspergillosis that were treated with itraconazole revealed that three of the four patients who received high doses (800 mg/d in the adults) of the drug responded favorably, while only two of the 16 patients who received a dose of 400 mg/d were cured. The use of high-dose itraconazole appears to be justified for high-risk patients with cerebral aspergillosis for whom conventional therapy has failed.