紫外分光光度法测定复方酮康唑软膏中酮康唑和氧氟沙星的含量

目的：建立复方酮康唑软膏的含量测定方法。方法：用双波长分光光度法测定酮康唑的含量，用单波长法测定氧氟沙星的含量。结果：两被测组分的平均回收率和相对标准偏差分别为酮康唑１００．３３％和０．３２％；氧氟沙星１００．８５％和０．２７％。结论：方法简便、准确，可用于复方酮康唑软膏的质量控制。     

酮康唑控释片的研制及体外溶出度考察

研制了酮康唑控释片，同时对它的体外溶出度进行了测定，并与市售普通片进行比较，结果表明：酮康唑控释片ｔ０．８＝４００．５０ｍｉｎ，而普通片ｔ０．８＝９９．４９ｍｉｎ，控释片释药平稳而持久。     

Treatment of vaginal candidiasis with ketoconazole, a new, orally active, antimycotic.

The efficacy of a new, orally active antimycotic, ketoconazole, in the treatment of vaginal candidiasis was studied at different doses involving 63 patients. All patients had subjective complaints and were mycologically positive. There was no significant difference in the cure rates of the different doses. The oral treatment was successful in 55 out of 63 patients (87.3%). No correlation was found between the relapse rate of vaginal candidiasis and the dose regimen. There were no serious side-effects, and no significant changes were reported in hematological and biochemical parameters.     

Change of Causative Organisms under Antifungal Treatment in Immunosuppressed Patients with HIV-Infections

Summary: Oral and esophageal candidosis are very common in HIV-infected patients. Due to the lack of efficacy of topical antimy-cotics in advanced stages of HIV-infection oral azoles are mainly used for treatment. holes most often used are ketoconazole and fluconazole. While Candida albicans clearly is the most frequently encountered yeast before and after treatment other species can be found somewhat less frequently after treatment. This especially applies to Candida glabrata. Candida spp. other than C. albicans obviously may cause manifest oral candidosis. This shift of microbes deserves the more interest as they are less susceptible to azole drugs.     

Visceral paracoccidioidomycosis in a gold miner from Brazil

Zusammenfassung: Es wird über einen 49-jährigen Deutschen berichtet, der nach 15-jährigem Aufenthalt in Südameri-ka an einer Paracoccidioidomykose er-krankte. Er litt an einer Cheilitis, einer erosiven Stomatitis, einer Laryngitis und einer beidseitigen Pilzpneumonie; außer-dem bestand der Verdacht auf ein Pilzgra-nulom des Gehirns. Die Diagnose wurde kulturell und serologisch gesichert. Die Ausbildung typischer Hefeformen mit mul-tiplen Sprossungen (“Steuerradformen”) benötigt oft länger als einen Monat (in die-sem Fall 6 Wochen), was die Diagnostik bei unklaren Krankheitsbildern erschwert. Der Patient wurde zunächst mit Amphotericin B und Sulfamethoxazol/Trimethoprim behandelt. Beide Medikamente muß-ten wegen Nebenwirkungen abgesetzt wer-den, obwohl Amphotericin B gut wirksam war. Ketoconazol war bei unserem Patien-ten weniger gut wirksam, während unter Itraconazol eine weitere deutliche Besse-rung eintrat. Nebenwirkungen wurden unter den beiden letztgenannten Medika-menten nicht beobachtet. Summary: We report on a 49 years old patient who developed paracoccidioidomycosis after working in a gold mine in South America. The patient suffered from cheilitis, stomatitis, laryngitis, and bilateral pneumonia. Additionally, there was evidence for cerebral granuloma. The diagnosis was confirmed by culture and serologic methods. Paracoccidioides brasilien-sis grows slowly and more than a month may elapse (in this case 6 weeks) before typical yeast-like forms with multiple buds (steering-wheel fungus cells) appear in culture, which often complicates the diagnosis if there is no typical clinical picture. The patient was treated with amphotericin B and sulfamethoxazole/trimethoprim, and a clinical response to therapy was observed. However, therapy had to be stopped because of severe side effects. Ketoconazole was less effective, but further clinical improvement was achieved under itraconazole without untoward side effects.     

Epidemic postsurgical Candida parapsilosis endophthalmitis. Clinical findings and management of 15 consecutive cases

Fifteen cases of postoperative Candida parapsilosis endophthalmitis occurring secondary to a contaminated lot of an irrigating solution were studied. All patients underwent a vitreous tap or diagnostic and therapeutic vitrectomy. Eleven of the 15 specimens were positive for the organism. Fourteen patients were treated with pars plana vitrectomy surgery. All patients were treated with intravitreal amphotericin B and systemic amphotericin B and 5-fluorocytosine. Two clinical recurrences were successfully treated with intravitreal amphotericin B, removal of the pseudophakos, and oral ketoconazole. The intraocular lens was retained in 11 of the 14 pseudophakic patients. Final visual acuities ranged from 20/25 to no light perception with eight of 15 patients having 20/60 or better visual acuities. Measurable levels of intraocular amphotericin B were found after systemic amphotericin B administration. Two patients with totals of 20 and 30 micrograms of intravitreal amphotericin B over 48 and 96 hours, respectively, had near normal ERGs one year later. Posterior capsulotomy and vitrectomy appear to decrease amphotericin B toxicity and allow sequential intraocular injection of this drug within a short time period.     

Pityriasis versicolor—Epidemiological and Therapeutical Study

Seventy-six patients with extensive pityriasis versicolor were divided into 3 groups and treated orally with ketoconazole, 200 mg daily, for 10, 20 or 30 days respectively. 50 patients out of this number completed the study. After 6 months, 46 patients were checked up. Eight of them developed relapses effectively treated with ketoconazole for another 15 days. Six out of these 8 patients belonged to the first group using ketoconazole for 20 days only. On the basis of this observation, we do not consider a 10 days' treatment to be sufficient and recommend that the patient should be treated for at least 20 days. As a preventive measure we recommend a daily bath with salicylic acid and sulphur soap. The frequency of the infection was higher in males (71.4%) than in females (28.6%). The youngest of the male patients was 4 months of age and the oldest 70 years. The youngest female was 4 months old and the oldest 50 years. Pityriasis versicolor was found to be predominant in the age group of 21--30 years. The sites most commonly involved were back, chest and the upper extremities.     

Additive Effect of the Combination of Griseofulvin and Ketoconazole Against Microsporum canis in Vitro: Additiver Effekt der Kombination von Griseofulvin und Ketoconazol gegen Microsporum canis in vitro

The susceptibility of 28 strains of Microsporum canis to griseofulvin, to ketoconazole and to a combination of both antifungal drugs was determined. Griseofulvin proved to be more active than ketoconazole. The combination of both antifungal agents was found to exert an additive effect.     

Oral and Gastrointestinal Candidosis: Prophylaxis During Immunosuppressive Therapy.

Summary: Patients with acute leukaemia and malignant lymphomas often are severely affected by fungal infections. There is in particular growing concern about disseminated candidosis. Oral, gastrointestinal and systemic candidosis seem to be closely linked. Predisposing factors are damaged mucosal barriers due to chemotherapy, protracted periods of neutropenia, and prolonged use of antibiotics and steroids.
Oropharyngeal candidosis is very frequent. This can be prevented or controlled by the application of topical antifungals such as nystatin. The systemic application of antifungals is an alternative for patients who do not respond. Both oral ketoconazole and intravenous amphotericin B have been proven effective. Candida oesophagitis is also an important problem. Oral nystatin suspension can be helpful in mild cases. In others oral ketoconazole and intravenous amphotericin B have to be used. A whole range of measures has to be taken to prevent spread of the disease, i.e. H,-antagonists should be used only if definitely needed. Specific antifungal prophylaxis has also been discussed. Oral amphotericin B seems to be helpful. The azole itraconazole might be especially promising.     

The Role of Candida Infections as an Adverse Effect upon Head and Neck Cancer Patients Undergoing Therapeutic Radiation and the Effect of Antimycotic Treatment

Summary: Oral, pharyngeal and esoph-ageal infections caused by Candida species occur very frequently when it comes to radiation therapy for head and neck cancer. In clinical terms oral candidosis is most often characterized by pseudomembranes or erythema. The erythematous form of oral candidosis has in particular to be distinguished from radiation mucositis. Candidosis of the oral and gastrointestinal tract often causes interruption of therapeutic radiation. Ketoconazole treatment is able to reduce the period of time during which the patient cannot be treated by radiation. Oral ketoconazole given at a daily dose of 200 mg is moreover superior to topical nystatin. To date, however, it is not yet clear if patients who have head and neck cancer in whom radiation therapy has to be started would profit from the prophylactic application of ketoconazole from start on.