棘白菌素的比较解答.pptVIP

卡泊芬净MIC90均低于1，对全部5346株念珠菌而言，卡泊芬净的平均MIC90最小。All isolates were tested in accordance with the standards in CLSI document M27-A3 (10). 作者从体外实验（无血清/50%血清）和动物模型试验（念珠菌血清粒缺鼠模型）两个角度探讨了三种棘白菌素类抗真菌药物对于近平滑念珠菌各亚型的敏感性和治疗效果。 发表于2012年Journal of Antimicrobial Chemotherapy（IF：4.659） 无血清检测时，仅卡泊芬净与阿尼芬净的MIC值有统计学差异 50%血清检测时，卡泊芬净与米卡芬净、阿尼芬净的MIC值均有统计学差异。 * * 共30株光滑念珠菌，21株来自血培养，9株来自呼吸道、消化道、以及泌尿道。 体外实验：采用棘白菌素药敏检测最为标准的方法CLSI肉汤稀释法，为更好的模拟体内环境，采用无血清法和50%血清法进行检测。 （1）体外实验（无血清）：虽然米卡芬净的MIC小于卡泊芬净，但是没有统计学意义；米卡芬净与卡泊芬净MIC均小于阿尼芬净，有统计学意义。 （2）模拟体内试验（50%血清）：加入血清后，棘白菌素类的MIC均有升高，但是此时卡泊芬净的MIC最低，且与阿尼芬净和米卡芬净有统计学意义 * Candida glabrata is a leading cause of disseminated candidiasis in most national surveillance studies. in some series is associated with worse outcomes compared with other Candida spp. 卡泊的适应症以美欧一致。食道、IC * * * 治疗启动时机很重要，因为数据显示延迟抗真菌治疗的起始时间会增高医院死亡率 * Abnormal changes in laboratory tests were classified as related disorders. For example, increased aspartate aminotransferase, alanine aminotransferase, and increased blood creatinine were classified as hepatobiliary, renal and urinary disorders, respectively * * 这个31荟萃分析研究中，分析了2009年8月前的随机抗真菌药物试验，伊曲康唑不耐受率高 * 在荟萃分析研究中，1）由于卡泊芬净肝毒性导致的抗真菌治疗终止比例只有0.2%，比其他几种抗真菌制剂都低。 2）使用AmB制剂、伊曲康唑和伏立康唑导致肝酶升高的比例很高。使用氟康唑导致肝酶升高的比例最低，但是考虑到广覆盖和经验性治疗，卡泊芬净更有优势。 The warning concludes that… Micafungin treatment should be conducted on a careful risk/ benefit basis, particularly in patients having severe liver function impairment or chronic liver diseases.This warning is based upon pre-clinical animal data that threshold for heptaocellular tumours in rats. The EU reviewers were concerned because the threshold for tumour development in rats was approximately in the range of clinical exposure. COMT 儿茶酚-O-甲基转移酶 including liver,breast cancer and cervical cancer cell lines. two primary catechol oestrogens, 2-hydroxycatechol oestrogen (2-OHE2) and 4-hydroxycatechol oestrogen (4-OHE2), which have been widely associated with the formation of oestrogenmediated cancers. * * Summary: At clinically ac