卡泊芬净联合伏立康唑、伊曲康唑或两性霉素B对尖端赛多孢子菌体外抑菌活性  

Antifungal activity of combination of caspofungin and voriconazole,itraconazole or amphotericin B against clinical strains of Scedosporium apiospermum in vitro

作　　者：万喆[1,2] 余进[1,2] 陈少杰[3] 李若瑜[1,2] 

机构地区：[1]北京大学第一医院皮肤科 [2]北京大学真菌与真菌病研究中心,北京100034 [3]福建医科大学附属第二医院皮肤科,福建泉州362000

出　　处：《中国临床药理学杂志》2010年第7期499-501,共3页The Chinese Journal of Clinical Pharmacology

摘　　要：目的观察卡泊芬净(棘白霉素类抗真菌药)联合伏立康唑、伊曲康唑(三唑素)或两性霉素B(多烯类),作用于15株尖端赛多孢子菌的体外抑菌活性。方法参照美国国家临床和实验室标准研究所(CLSI)的M38-A方案,药物间相互作用用分数抑菌浓度(FIC值)表示。结果体外单独用药时,伏立康唑的MIC值的几何均数(GM)显著低于其他药物。在15株受试菌中,卡泊芬净与伊曲康唑联合时,全部菌株显示为协同作用;卡泊芬净与两性霉素B联合时,有27%的菌株显示为协同作用;卡泊芬净与伏立康唑联合时,均表现为无关作用。结论卡泊芬净可增强伊曲康唑的体外抗真菌活性,卡泊芬净与伊曲康唑联合用药有望作为临床上治疗尖端赛多孢子菌感染的一种有效方法。Objective To investigate the in vitro antifungal activity of combination of caspofungin and voriconazole, itraconazole and amphotericin B against clinical strains of Scedosporium apiospermum. Methods Synergy tests were performed using the checkerboard method and following CLSI （Clinical and Laboratory Standards Institute, formerly NCCLS） M382A broth microdilution methods. In vitro interactions were evaluated with fraction inhibitory concentration index （FICI）. Results The GM value of voriconazole alone uasage was lower than other antifungal agents in the study significantly. Caspofungin and itraconazole were synergistic for all isolates of S. apiospermum in the study. Caspofungin and amphotericiu B showed synergistic for 27% of all S. apiospermum. Indifferent effect was found in combination of caspofungin and voriconazole for all isolates. Conclusion Caspofungin increased antifungal activity of itraconazole in vitro. The combination of caspofungin and itraconazole seems a good choice of antifungal therapy against S. apiospermum infection.

关 键 词：尖端赛多孢子菌 抗真菌药物敏感性试验 卡泊芬净 

分 类 号：R969.4[医药卫生—药理学] R978.5[医药卫生—药学]