伊曲康唑与两性霉素B抗新生隐球菌临床分离株的实验研究  

Study on Combination of Itroconazole and Amphotericin B Against Clinical Isolates of Cryptococcus neoformans

作　　者：郭秀军[1] 廖万清[1] 任大明[1] 徐红[1] 

机构地区：[1]第二军医大学长征医院皮肤科,上海200003

出　　处：《中华皮肤科杂志》2003年第12期711-713,共3页Chinese Journal of Dermatology

摘　　要：目的评价新生隐球菌临床分离株对伊曲康唑与两性霉素B联合用药的敏感性及两药物之间相互作用的方式。方法采用美国国家临床实验室标准化委员会M27-A推荐的棋盘微量稀释法,检测了20株新生隐球菌临床分离株对伊曲康唑、两性霉素B及两药联合的体外药物敏感性,同时对两药的作用方式进行了判定。结果联合用药时,伊曲康唑MIC值的几何均数从0.2730μg/mL显著降低到0.1195μg/mL,两性霉素BMIC值的几何均数从0.6830μg/mL显著降低到0.2102μg/mL,35%受试菌表现为协同作用方式,55%的受试菌株表现为相加作用方式,10%受试菌株表现为无关作用方式,未观察到拮抗作用的出现。测定不同浓度下药物单独和联合作用的1株菌的菌落形成单位(cfu/mL),联合用药组都较单独用药有明显减少。结论伊曲康唑与两性霉素B联合较任一药物单独用药体外抗新生隐球菌的活性高。Objective To evaluate the sensitivity of combination of itraconazole and amphotericin B to20clinical isolates of Cryptococcus neoformans and their in vitro interactions.Methods The sensitivity of combination of itraconazole and amphotericin B and their in vitro interactions were determined with20clinical isolates of C.neoformans by a checkerboard titration broth microdilution-based method in accord with the recommendations of the National Committee for Clinical Laboratory Standards(NCCLS),USA.Results When both drugs were given in combination,there was significant reduction of geometric means of MICs for itraconazole(from0.2730to0.1195μg/mL)and for amphotericin B(from0.6830to0.2102μg/mL).Synergistic effects were found in35%of isolates,additive effects in55%of isolates,and indifferent effects in10%of isolates.Antagonistic effects were not observed.The colony formation unit(cfu)per millilitre was significantly decreased in an isolate which was treated with different concentrations of the combination of both drugs,in comparison to that with the corresponding concentrations of individual drug.Conclusion The combination of itraconazole and amphotericin B is significantly more active against C.neoformans in vitro than individual drug alone.

关 键 词：两性霉素B 伊曲康唑 新生隐球菌 临床分离株 联合用药 几何均数 单独用药 棋盘 方式 结论 

分 类 号：R965[医药卫生—药理学]