GMP

()

:
,
50 150


. , 80%
Candida
albicans
( ) . 50%
, 8- 100 000
, .. 75%
.

, ,
. Candida spp.,
,
, Candida spp.
4 [ ..,
.., ..
. - , 2000, .2., N1, c. 24-28. ].
- 8-11
. 27
77% [. Pelz R.K. Lipsett P.A., Swoboda S. et al. Candida Infections: Outcome and Attributable
ICU Costs in Critically Ill Patients. - J Intensive Care Med 2000; 15; 255-261.].
, Candida,
, , , ,
[British Society for Antimicrobial Chemotherapy Working Party. Management of deep Candida
infection in surgical and intensive care unit. - Intensive Care Med, 1994; 20; 522-528. ].
Candida albicans,
Candida, Candida non-albicans.
, , 30
, Candida non-albicans (Candida krusei, Candida
tropicalis Candida parapsilosis) 30% [Walsh T.J. Global expamsion of
nosocomial candidiasis. - Int J Inf Dis, 1997, 1 (Suppl 1), S.1. ].
, C. albicans, .

()
( 1).

. 306.271 g/mol

. 1.

 ,
(, , )
(, , , , , )
. ,


.

()
.
, -450-
14-,
.
,
.
.
.
[Warnock D.W. Fungal
infections in neutropenia: current problems and chemotherapeutic control. - JAC, 1998, V.41
(Suppl.D), 95-105.]. , ,
.
.

, .. Candida spp.
( ), Cryptococcus
neoformans ( ), Microsporum spp. Ttichoptyton spp;
, Blastomyces dermatitides, Coccidioides immitis,
, Histoplasma capsulatum
.
(.albicans, C.parapsilosis, C.tropicalis, C.lusitaniae .),
, .
, , .
. in vitro C. albicans
. , , , 3,2%
C. albicans 2,4%
[ .., .. :

. - , 2001, .3.
N.6, . 178-182.]. C. non-albicans C. krusei.
C. glabrata.

. 450 ,
;

450 (
, , .

- (
),
, ,
, .
90% . 90%. Cmax 0,5-1,5 90%
/ (2.5-3.5 /).
4-5 .
(11%),
99%. ,
, .
. .
, , ,
.
8
24 .
.
80% .
, ,
( ). 150 7
- 23.4 /, - 7.1
/; 4 150 1 - 4.05
/ 1.8 / - .
. ,
(60-75% ), 8-10% -
, . 30 ,
1 .
,
.
34 .
, 2
.
,
2 .

:
:
:
( ,
,

),

 ,
,
.
:
(),
,
(, , , ),
, , ,
,
,
: ,
,
, , ,

:
, ( , ),
,
.

:
.

.
.
:
: 400 , 200 - 400
.
;
6 - 8 .
, ,
200 / .
, , .
200-400 / 2 .
; 11-24
; 2-17 ; 1-16 ;
3-17 .
() , ,
, : 400
, - 200 .
400 /.
.

 : - 50 - 100 , 7 14 . ,
.
: 50
14 .
, ,
, ,
.., 50-100 /
14-30 .

150 1 .
: 150 .
: 150 1 .
; 4 12 .
.
: 150 .
.
50-400 1 /
.
,
, 400
1 /.
; 1000/ 3
7 .
, : 150 1 50 ,
- 2 - 4 , - 6 .
: 50 2 - 4 300 1
2 . 300 ,
300-400
.
: 150 1 .
.
3-6 6-12 .

,
.
:
, ,
.
, .
1 /.
: 6 / , 3
/ .
() , ,
, : 6 - 12 //
.


: 3 - 12 / (
,
).
(
, ),
.
4:
, ,
: 2
72 , 2 4 - 48 .
:
.
( 50 /)
.
:
.
() 50 400 .

, :

/

> 50

11 - 50

48 24

:
, .
: , .
,
.
. 3
50%.
:



( , ).
:
, QT ( .. ),
400 .
:
,
.
, .
, ,
,
.
:
, ,
.

:
.
[Winston D.J., Hathorn J.W., Schuster
M.G. et al. A Multicenter, Randomized Trial of Fluconazole versus Amphotericin B for Empiric
Antifungal Therapy of Febrile Neutropenic Patients with Cancer. - Am J Med, 2000; 108; 282289. ].
, ,
.
1%.
, , ,
-, .
/ , ,
, , .

.
, , , , , ,
, , .
:
-
. .
,
.
, .
.
,
.

 ,
( -,
, ).
, , ( .
).
[Ally R., Schurmann D., Kreisel W. et al. A randomized, Double-Blind,
Double-Dummy, Multicenter Trial of Voriconazole and Fluconazole in the Treatment of
Esophageal Candidiasis in Immunocompromised Patients. - Clin Infect Dis, 2001; 33; 144754.].

: ,
, ,
.
.
( 400 ): -
QT ,
,
400 .
: QT
,
. , , .
: QT .

,
:
.
:
.

CYP 2C9 450
CYP 3A4.
,
CYP 2C9 CYP 3A4 (
, ). 4
5 .

 :
, ,
, ,
( ).
:
AUC 2 55%.
:

.
, ,
.
:
.
:
AUC .
AUC
.
.
:
, , , ,
, CYP 3A4.

, .
:
AUC
.
:
200 . AUC 55%.
--:
-- .
AUC
.
:
.
: /
AUC .
:
.
:
.
: 14
.

 :
.
:
AUC .

,
, ,
, .

,
:

, 1

( . .
);

-
-
-