卡斯波芬金
棘白菌素
医学
耶氏肺孢子虫
肺孢子虫肺炎
肺炎
皮疹
白霉素类
曲菌病
挽救疗法
重症监护医学
巨细胞病毒
内科学
免疫学
抗真菌
皮肤病科
两性霉素B
氟康唑
人类免疫缺陷病毒(HIV)
化疗
疱疹病毒科
病毒性疾病
作者
Darius Armstrong‐James,Justin Stebbing,John Liu,A. Murungi,Mark Bower,Brian Gazzard,Michael J. Nelson
出处
期刊:Thorax
[BMJ]
日期:2010-09-29
卷期号:66 (6): 537-538
被引量:52
标识
DOI:10.1136/thx.2010.135350
摘要
Pneumocystis jirovecii pneumonia (PCP) remains a major cause of mortality in patients with HIV; we read with enormous interest the recent PCP mortality prediction rule stratifying 451 patients by mortality at the time of illness presentation.1 The first-line treatment for this infection, cotrimoxazole, is associated with a number of adverse effects, including rash, leucopenia, thrombocytopenia and interstitial nephritis.2 Therefore, treatment with cotrimoxazole significantly adds to the morbidity associated with this condition and we note in this study that this was the main treatment used.
One of the identifying characteristics of P jirovecii is the presence of (1,3)-β-d-glucan in its cell wall.3 As the cell wall of this organism does not contain ergosterol (the target of azoles and polyenes), echinocandins, which target the synthesis of (1,3)-β-d-glucan, are likely to be the only effective antifungals for PCP.4
Caspofungin was the first echinocandin licensed for empiric antifungal treatment in candidiasis and aspergillosis. In animal …
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