两性霉素B不同剂型临床合理应用多学科专家共识(2024版)  

Multidisciplinary expert consensus on the clinical rational application of different formulations of amphotericin B(2024 edition)

作　　者：中国医药教育协会真菌病专业委员会 王睿[2] 黄晓军[3] 俞云松[4] 王明贵 李若瑜[6] 徐英春 朱曼[8] 佘丹阳[9] 蔡芸[10] Medical Mycology Society of Chinese Medicine and Education Association;Wang Rui;Huang Xiaojun;Yu Yunsong;Wang Minggui;Li Ruoyu;Xu Yingchun(不详;Center of Medicine Clinical Research,Department of Pharmacy,Medical Supplies Center of Chinese PLA General Hospital,Beijing 100039,China;Peking University People′s Hospital,Peking University Institute of Hematology,Beijing 100044,China;Zhejiang Provincial People′s Hospital,Hangzhou 314408,China;Institute of Antibiotics,Huashan Hospital,Fudan University,Shanghai 200040,China;Peking University First Hospital,National Clinical Research Center for Skin and Immune Diseases,Beijing 100034,China;Department of Laboratory Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]不详 [2]解放军总医院药剂科药物临床研究室,北京100039 [3]北京大学人民医院、北京大学血液病研究所,北京100044 [4]浙江省人民医院,杭州314408 [5]复旦大学附属华山医院抗生素研究所,上海200040 [6]北京大学第一医院、国家皮肤与免疫疾病临床医学研究中心,北京100034 [7]中国医学科学院、北京协和医学院、北京协和医院检验科,北京100730 [8]解放军总医院药剂科 [9]解放军总医院呼吸与危重症医学部 [10]解放军总医院药剂科药物临床研究室

出　　处：《中华内科杂志》2024年第3期230-257,共28页Chinese Journal of Internal Medicine

摘　　要：两性霉素B(AmB)是临床治疗侵袭性真菌病(IFD)广谱强效的多烯类抗真菌药物。目前已有两性霉素B脱氧胆酸盐(AmB-D)及3种AmB脂质剂型,包括两性霉素B脂质体(L-AmB)、两性霉素B胶状分散体(ABCD)和两性霉素B脂质复合物(ABLC)可供临床使用。根据临床在选择AmB不同剂型方面关注与困惑的问题,本共识结合国内外最新临床研究证据、指南、共识以及临床经验,针对AmB 4种不同剂型的药剂学特点、抗真菌作用机制、药代动力学/药效学、药物相互作用、适应证、用法用量、局部用药、不良反应防治等特点,明确AmB在IFD目标治疗的剂型与剂量选择,并对特殊人群的用法用量加以规范,为该类药物的临床决策与合理应用提供指导意见。Amphotericin B(AmB)is a broad-spectrum and potent polyene antifungal drug for the treatment of invasive fungal diseases(IFDs).Currently,amphotericin B deoxycholate(AmB-D)and three AmB lipid formulations,namely liposomal amphotericin B(L-AmB),amphotericin B colloidal dispersion(ABCD),and amphotericin B lipid complex(ABLC)are available for clinical use.In view of clinical concerns and misperceptions in the selection of different formulations of AmB,the present consensus summarized their pharmaceutical characteristics,antifungal mechanism,pharmacokinetics/phamacodynamics,drug interactions,indications,dosage,local administration,and adverse reactions based on the latest clinical research evidence,guidelines,and clinical experience.This consensus also recommends formulation selection and dosage adjustment for the treatment of target IFDs and in special populations,thereby providing expert consensus for clinical decision-making and standardized application of AmB.

关 键 词：两性霉素B 侵袭性真菌病 两性霉素B脱氧胆酸盐 两性霉素B脂质体 两性霉素B胶状分散体 两性霉素B脂质复合物 共识 

分 类 号：R969[医药卫生—药理学]