伊曲康唑联合特比萘芬治疗孢子丝菌病疗效及其对病原真菌体外抗菌活性研究

Combination of itraconazole and terbinafine in treating sporotrichosis and their in vitro antifungal activities against Sporothrix schenckii

目的初步探讨伊曲康唑和特比萘芬联合治疗孢子丝菌病的疗效,评价两药体外联合对申克孢子丝菌菌丝相和酵母相的抗菌活性。方法口服伊曲康唑200 mg/d和特比萘芬250 mg/d治疗孢子丝菌病;体外联合药敏试验采用棋盘微量稀释法,计算分数抑菌浓度(FIC)指数判定两药相互作用具有协同、拮抗或无关作用。结果伊曲康唑和特比萘芬联合成功治愈3例经伊曲康唑治疗无效的孢子丝菌病患者。两药体外联合对申克孢子丝菌菌丝相具有75%的协同作用,对酵母相为70%(P=0.50)。结论初步研究显示伊曲康唑和特比萘芬联合治疗孢子丝菌病有效安全,体外联合药敏试验显示两药具有较高的协同作用。

Objective To evaluate the efficacy of the combination of itraconazole and terbinafine in treating sporotrichosis and against Sporothrix schenckii growing in both mycelial and yeast phases.Methods The combination of itraconazole（200 mg/d） and terbinafine（250 mg/d） was applied in the treatment of sporotrichosis.In vitro effects against Sporothrix schenckii in two growth phases were evaluated by checker-board method,and fractional inhibitory concentration（FIC） index was caculated to determine whether the interaction was synergistic,indifference,or antagonistic.Results Three patients failed in itraconazole therapy were cured with the combination of itraconazole and terbinafine.Synergistic interactions of itraconazole and terbinafine against Sporothrix schenckii in mycelial form and in yeast form,were observed to be 75% and 70% respectively（P=0.50）.Conclusions The combination of itraconazole and terbinafine is efficient and safe in treating sporotrichosis with perfect synergy.