伏立康唑治疗隐球菌病血药浓度不足1例  

Suboptimal voriconazole plasma concentration during cryptococcal treatment:a case report

作　　者：廖荣强 王秀娟 何瑶[1] 郑晓媛 LIAO Rongqiang;WANG Xiujuan;HE Yao;ZHENG Xiaoyuan(Pharmacy Department,Chongqing Emergency Medical Center,Chongqing 400014,China;Department of Respiratory Medicine,Chongqing Emergency Medical Center,Chongqing 400014,China)

机构地区：[1]重庆市急救医疗中心药剂科,重庆400014 [2]重庆市急救医疗中心呼吸内科,重庆400014

出　　处：《中国真菌学杂志》2024年第3期285-287,305,共4页Chinese Journal of Mycology

基　　金：重庆市临床药学重点专科建设项目[渝卫办发(2023)69号]。

摘　　要：隐球菌感染主要由新生隐球菌引起,可攻击肺和中枢神经系统等人体组织。该文报道1例极可能为CYP2C19快代谢型患者感染隐球菌,在抗感染治疗期间先后经历氟康唑耐药及伏立康唑反复血药浓度不足的问题,最终及时调整为两性霉素B脂质体联合氟胞嘧啶治疗方案得到改善。通过此病例分析,旨在为临床实践提供有价值的参考。Cryptococcal infection is mainly caused by Cryptococcus neoformans,which can attack human tissues such as lung and central nervous system.This paper presents a case of cryptococcal infection in a patient with a high probability of being a rapid metabolizer of CYP2C19,who experienced successive issues of fluconazole resistance and suboptimal voriconazole plasma concentration during the course of anti-infective treatment.Timely adjustment to a combined therapeutic regimen of amphotericin B liposome and flucytosine ultimately led to clinical improvement.This case analysis aims to provide valuable insights and reference for clinical practice.

关 键 词：隐球菌 耐药 血药浓度 伏立康唑 CYP2C19快代谢型 

分 类 号：R519.4[医药卫生—内科学]