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【Meeting E-News】口服抗病毒药治疗急性感染方便有
Nov 13, 2006
Oral antiviral medications offer an effective, more convenient option compared with topical antiviral therapy for patients with acute infectious ulcers associated with herpes simplex keratitis, increasing the likelihood of therapy adherence, Deborah P. Langston, MD, FACS, told a full-capacity crowd at a symposium on eye infections Monday.
Topical trifluridine (Viroptic) therapy begins at nine times a day for 5 days, "and if things are going well, you can drop the dose to five times a day for a total of 14 to 21 days," said Dr. Langston, of the Massachusetts Eye and Ear Infirmary, Boston. At 14 days, about 95% of the ulcers will be healed, but the dosing is inconvenient, leading to noncompliance.
"And there's also a significant chance of toxicity in the form of conjunctivitis, punctate keratitis, partial occlusion, or contact dermatitis," she said.
Alternatively, oral antiviral medications can treat acute infections in 14 to 21 days. The options include acyclovir (Zovirax), famciclovir (Famvir), and valacyclovir (Valtrex).
"Acyclovir is given in doses of 400 mg three to five times a day, with the five-times-a-day dose generally used in patients who are atopic or otherwise immuno-altered," said Dr. Langston, who is an associate professor of ophthalmology at Harvard Medical School.
"There's also a pediatric suspension available, and that is given in doses of 200 mg per teaspoon, or 5 ml, four times a day," she said.
Famciclovir is prescribed in doses of 125 to 250 mg twice daily, and valacyclovir dosing is 500 mg twice daily, Dr. Langston said.
Dr. Langston pointed out that all of these drugs are FDA-approved, but "for the eye, this is off-label use."
Also, she said, valacyclovir should be used only in immunocompetent patients on long-term treatment because of a risk of fatal hemolytic uremia in severely immunocompromised patients on long-term therapy. 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 口服抗病毒药治疗急性感染方便有效
2006年11月13日
本周一在一场眼部感染专题讨论会上美国外科医师学会会员Deborah P. Langston博士告诉满场听众，口服抗病毒药物治疗在局部抗病毒疗法之外为单纯疱疹性角膜炎相关的急性感染性溃疡提供了一个有效而且更方便的选择，使得联合治疗的可能性增大。
局部三氟哩啶（曲氟尿苷）治疗开始每日9次共5日，“如果情况好转，可以减少剂量到每日5次共14到21日” 位于波士顿的马萨诸塞州眼与耳医疗中心的Langston博士说。在14天内，约95%的溃疡将愈合，但该剂型并不方便，导致了患者不配合。
她说：“在结膜炎、点状角膜炎、部分性遮闭或接触性皮炎等类型中使用也会有很大机会出现毒性作用。”
或者口服抗病毒药物治疗可在14到21天内治愈急性感染。可选择的药物包括阿昔洛维（舒维疗）、泛西洛维（泛维尔）和伐昔洛韦（维德思）。
“阿昔洛维剂量为每次400mg每日5次。这种每日5次的剂量广泛用于遗传过敏要不然就是免疫改变的患者”，哈佛大学医学院眼科副教授Langston博士说。
“也有儿科用乳剂，剂量为200mg每茶勺或5ml，每日4次。”她说。
Langston博士说，泛西洛维的处方剂量为125到250mg，每日两次，而伐昔洛韦的剂量为500mg每日两次。
Langston博士指出所有这些药物都经（美国）食品与药物管理局批准，但是“对于眼部，则是非官方核准的用法（非标签指出的用法）。”
她也说，泛西洛维在长期用药时只应当用于具有免疫活性的患者，因为在严重免疫低下的患者长期应用有发生致命性的溶血的危险。 Oral antiviral medications offer an effective, more convenient option compared with topical antiviral therapy for patients with acute infectious ulcers associated with herpes simplex keratitis, increasing the likelihood of therapy adherence.
口服抗病毒药物治疗在局部抗病毒疗法之外为单纯疱疹性角膜炎相关的急性感染性溃疡提供了一个有效而且更方便的选择，使得联合治疗的可能性增大。
与局部抗病毒疗法相比口服抗病毒药物治疗有效、更为方便，增加了治疗的依从性。
And there's also a significant chance of toxicity in the form of conjunctivitis, punctate keratitis, partial occlusion, or contact dermatitis.
在结膜炎、点状角膜炎、部分性遮闭或接触性皮炎等类型中使用也会有很大机会出现毒性作用。
也会有很大机会出现毒性作用，表现为结膜炎、点状角膜炎、部分性闭塞或接触性皮炎。
immunocompetent patients 免疫健全的患者
hemolytic uremia 溶血性尿毒症 [标签:content1][标签:content2]
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作者:admin@医学,生命科学 2011-05-27 05:11
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