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近年来真菌感染的发病率呈上升趋势。随着抗真菌药物的广泛应用,临床出现的耐药菌株数也在增多。合理选用抗真菌药物治疗对患者的预后有重要意义。本文将近年来国内外临床常见的酵母菌感染及耐药现状进行综述,以帮助临床合理选择初始治疗的抗真菌药物。 相似文献
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近年来,真菌感染患者的发病率和死亡率持续上升,但现有抗真菌药物种类依然非常少,并且耐药现象的出现使临床可选择的抗真菌药物变得更加有限.因此,对新的抗真菌药物的开发迫在眉睫,从天然产物中寻找新型高效的抗真菌药物成为目前的研究热点之一.从天然产物中筛选出具有抗真菌活性的天然化合物,有助于扩大治疗真菌感染疾病的可选药物种类,减少耐药的发生.该文归纳现有报道的具有抗真菌活性的化合物,根据其不同来源及不同化学结构进行分类,阐明不同类别天然化合物的抗真菌作用机制,为开发新型高效抗真菌药物提供前体结构及抗真菌新靶点. 相似文献
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摘要目的:探讨认知疗法合并舍曲林治疗产后抑郁症患者的临床疗效。方法:将本院2011 年10 月至2012 年7 月收治的76 例
产后抑郁症患者按随机数字表法分为认知疗法合并舍曲林治疗组(试验组,38 例)和舍曲林单独治疗组(对照组,38 例),进行临床
随机双盲对照试验,采用17 项汉密尔顿抑郁量表(Hamilton Depression Rating Scale,HAMD)、临床整体量表- 疗效总评估量表
(Clinical Global Impression,CGI) 评价和比较两组的临床疗效。结果:(1) 试验组的有效率显著高于对照组,差异有统计学意义
[92.11%vs 81.58 %),P<0.01],试验组第2、3 阶段的临床有效率均显著高于对照组,差异有统计学意义(P<0.05)。(2) 与治疗前相
比,两组患者治疗后的HAMD、CGI-SI 总分均降低,差异有统计学意义(P<0.01);治疗第1、2、3 阶段,试验组HAMD、CGI-SI 减分
值均显著高于对照组,差异有统计学意义(P<0.05)。结论:认知疗法联合舍曲林治疗产后抑郁症的短期治疗内疗效显著优于舍曲
林单独治疗。 相似文献
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目的 从常用免疫抑制剂、降血脂药、抗抑郁药、抗生素及非甾体类抗炎药中筛选出可能与氟康唑具有协同增效作用的药物.方法 将5类28种药物配制成相同浓度(100 μg/mL)后分别单独及与低浓度氟康唑联合加入白念珠菌耐药菌株(l00、103)及敏感菌株(sc5314、y0109)菌悬液中,24 h(敏感菌)及48 h(耐药菌)后观察菌液澄清情况,菌液完全澄清为“+”,混浊为“-”,并重复上述实验3次.结果 舍曲林等7种药物在该浓度下单用即可抑制所有实验菌株生长,与氟康唑合用后抑菌作用更加显著;利福喷丁等6种药物在该浓度下单用只能抑制敏感菌株生长,但与低浓度氟康唑合用后对耐药菌株也有抑制作用.结论 舍曲林、利福喷丁等药物与氟康唑联合后对白念珠菌可能具有协同抑制作用. 相似文献
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目的:探讨认知疗法合并舍曲林治疗产后抑郁症患者的临床疗效。方法:将本院2011年10月至2012年7月收治的76例产后抑郁症患者按随机数字表法分为认知疗法合并舍曲林治疗组(试验组,38例)和舍曲林单独治疗组(对照组,38例),进行临床随机双盲对照试验,采用17项汉密尔顿抑郁量表(HamiltonDepressionRatingScale,HAMD)、临床整体量表一疗效总评估量表(ClinicalGlobalImpression,CGI)评价和比较两组的临床疗效。结果:(1)试验组的有效率显著高于对照组,差异有统计学意义[92.11%VS81.58%),P〈0.01],试验组第2、3阶段的临床有效率均显著高于对照组,差异有统计学意义(P〈0.05)。(2)与治疗前相比,两组患者治疗后的HAMD、CGI.SI总分均降低,差异有统计学意义(P〈0.01);治疗第1、2、3阶段,试验组HAMD、CGI—SI减分值均显著高于对照组,差异有统计学意义(P〈0.05)。结论:认知疗法联合舍曲林治疗产后抑郁症的短期治疗内疗效显著优于舍曲林单独治疗。 相似文献
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目的评估舍曲林抗新生隐球菌的效果。方法实验分为6组,分别为空白对照组、10 mg/mL氟康唑、10 mg/mL舍曲林、20 mg/mL舍曲林、10 mg/mL氟康唑联用10 mg/mL舍曲林以及10 mg/mL氟康唑联用20 mg/mL舍曲林组。通过体外药敏试验及BALBc小鼠新生隐球菌动物探讨各组间抗隐球菌效果的差异。结果体外药敏试验发现舍曲林可有效降低新生隐球菌菌落数,当与氟康唑联用时抑菌效果更显著。动物实验发现2种浓度的舍曲林都可明显降低感染小鼠实验早期脑、肺组织的新生隐球菌菌落数,但在实验后期,低浓度的舍曲林对感染小鼠脑组织失去抑菌作用。脑、肺组织中,舍曲林治疗对新生隐球菌的抗菌效果均不如氟康唑。舍曲林与氟康唑联合用药对新生隐球菌模型小鼠肺组织的抗菌效果强于单用舍曲林或氟康唑。结论舍曲林具有抗新生隐球菌的作用,当与氟康唑联合用药时可起到协同作用。 相似文献
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《Bioorganic & medicinal chemistry》2020,28(7):115398
In the recent past, prevalence of life threatening fungal diseases have increased rapidly in immune-compromised cases such as acquired immunodeficiency syndrome (AIDS), cancer, organ transplant etc. Side by side, the appearance of drug resistance to the presently available antifungal therapeutics is on a rapid rise. It has become a top priority for the academia and pharmaceutical industries to develop new antifungal agents able to combat this resistance, and at the same time, possess potential broad spectrum of activity and minimum toxicity. An understanding of the pharmacological interactions between antifungal agents and their targets offers opportunities for design of new therapeutics. This review discusses the various methodology of drug design, structure activity relationships (SARs), and mode of action of variety of new antifungal agents. 相似文献
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The development of reliable procedures for detecting resistance in vitro to antifungal agents and the increase in the prevalence of mycoses due to organisms with intrinsic or secondary resistance have reinforced the clinical relevance of antifungal susceptibility testing. A matter is currently in the limelight: can antifungal agents indications be based on susceptibility testing results? The present paper reviews the reliability of susceptibility testing procedures available at the moment, their capability for predicting therapeutic failure, and their clinical usefulness. 相似文献
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Invasive Candida infections are a leading cause of morbidity and mortality in the neonatal intensive care unit (NICU). Extremely preterm and very low birth weight infants are at the highest risk of infection. There are currently no antifungal agents that have FDA-labeling for the treatment of invasive candidiasis in the neonatal population. Based on the current IDSA guidelines, amphotericin and fluconazole are considered first-line options for neonatal candidiasis. The newer antifungal agents (i.e., echinocandins and voriconazole) are currently considered second-line or salvage therapy; however, evidence supporting their use is emerging. This review focuses on the supporting evidence for the selection of antifungal agents for treatment of invasive Candida infections in the NICU. 相似文献
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Systemic fungal infections are increasing in prevalence, especially in immunocompromised patients and post-surgical patients. The rise in systemic fungal infections has resulted in increased utilization of antifungal agents which, in turn, has contributed to escalating resistance rates as seen by the increasing number of fungal pathogens added to the Centers for Disease Control and Prevention Antimicrobial Resistance Threats Report in 2019. Unfortunately, there are few novel antifungal agents coming to market to combat these ever-increasing resistance rates. In this review, we cover the current climate of antifungal agents and explore agents coming through the pipeline and potentially to market. We also discuss the indicated uses for empiric and targeted antifungal therapies as well as the need to include antifungal agents as a part of antimicrobial stewardship programs that focus heavily on antibacterial agents. 相似文献
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Both the incidence of invasive fungal infections and the number of antifungal agents available to clinicians have expanded
significantly over the past two decades. Successes with pharmacokinetic and pharmacodynamic evaluations of other antimicrobial
agents in animal models and their clinical correlations with patient outcomes have led to an increased number of studies evaluating
both old and new antifungal agents. Recently, animal models have successfully defined target pharmacodynamic indices for many
antifungal agents and fungal infections, but validation of these targets in human studies is frequently lacking. This article
evaluates the potential pros and cons of extrapolating to humans the animal data on antifungal pharmacodynamics. 相似文献
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Thomas Lehrnbecher Konrad Bochennek Dominik Schrey Andreas H. Groll 《Current fungal infection reports》2011,5(2):103-110
Invasive fungal infections still play a major role in morbidity and mortality in pediatric patients, especially in children
undergoing therapy for an underlying malignancy and in preterm infants. Relative to the adult population, pediatric age groups
display important differences not only in host biology, predisposing conditions, epidemiology, and presentation of fungal
infections, but also in the disposition and clearance of antifungal compounds. During the past decade, several new antifungal
agents have been developed. Although not all of these agents are yet approved for children, the pediatric development of antifungal
agents has moved forward in an exemplary manner, which is essential for the successful management of the individual patient.
This article reviews the current data on pharmacokinetics, safety, and dosing of antifungal agents in pediatric patients. 相似文献
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A number of benzoic acid analogues showed antifungal activity against strains of Aspergillus flavus, Aspergillus fumigatus and Aspergillus terreus, causative agents of human aspergillosis, in in vitro bioassays. Structure-activity analysis revealed that antifungal activities of benzoic and gallic acids were increased by addition of a methyl, methoxyl or chloro group at position 4 of the aromatic ring, or by esterification of the carboxylic acid with an alkyl group, respectively. Thymol, a natural phenolic compound, was a potent chemosensitizing agent when co-applied with the antifungal azole drugs fluconazole and ketoconazole. The thymol-azole drug combination demonstrated complete inhibition of fungal growth at dosages far lower than the drugs alone. Co-application of thymol with amphotericin B had an additive effect on all strains of aspergilli tested with the exception of two of three strains of A. terreus, where there was an antagonistic effect. Use of two mitogen-activated protein kinase (MAPK) mutants of A. fumigatus, sakAΔ and mpkCΔ, having gene deletions in the oxidative stress response pathway, indicated antifungal and/or chemosensitization activity of the benzo analogues was by disruption of the oxidative stress response system. Results showed that both these genes play overlapping roles in the MAPK system in this fungus. The potential of safe, natural compounds or analogues to serve as chemosensitizing agents to enhance efficacy of commercial antifungal agents is discussed. 相似文献
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Santi M. Mandal Denial Mahata Ludovico Migliolo Aditya Parekh Partha S. Addy Mahitosh Mandal Amit Basak 《The Journal of biological chemistry》2014,289(37):25468-25473
Effects of glucose on the susceptibility of antifungal agents were investigated against Candida spp. Increasing the concentration of glucose decreased the activity of antifungal agents; voriconazole was the most affected drugs followed by amphotericin B. No significant change has been observed for anidulafungin. Biophysical interactions between antifungal agents with glucose molecules were investigated using isothermal titration calorimetry, Fourier transform infrared, and 1H NMR. Glucose has a higher affinity to bind with voriconazole by hydrogen bonding and decrease the susceptibility of antifungal agents during chemotherapy. In addition to confirming the results observed in vitro, theoretical docking studies demonstrated that voriconazole presented three important hydrogen bonds and amphotericin B presented two hydrogen bonds that stabilized the glucose. In vivo results also suggest that the physiologically relevant higher glucose level in the bloodstream of diabetes mellitus mice might interact with the available selective agents during antifungal therapy, thus decreasing glucose activity by complex formation. Thus, proper selection of drugs for diabetes mellitus patients is important to control infectious diseases. 相似文献