In recent years, the prevalence of respiratory fungal diseases has increased. Polyene antifungal drugs play a pivotal role in the treatment of these conditions, with amphotericin B (AmB) being the most representative drug. This study aimed to evaluate the efficacy and safety of topical administration of AmB in the treatment of respiratory fungal infections. We conducted a retrospective study on hospitalized patients treated with topical administered AmB for respiratory fungal infections from January 2014 to June 2023. Data from 36 patients with invasive pulmonary fungal infections treated with topical administration of AmB were collected and analyzed. Nebulization was administered to 27 patients. After the treatment, 17 patients evidenced improved conditions, whereas 10 patients did not respond and died in the hospital. One patient experienced an irritating cough as an adverse reaction. Seven patients underwent tracheoscopic instillation, and two received intrapleural irrigation; they achieved good clinical therapeutic efficacy without adverse effects. The combined application of systemic antifungal treatment and topical administration of AmB yielded good therapeutic efficacy and was well-tolerated by the patients. Close monitoring of routine blood tests, liver and kidney function, and levels of electrolytes, troponin, and B-type natriuretic peptide supported this conclusion.

中文翻译：

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外用两性霉素B治疗呼吸道真菌感染的应用及评价

近年来，呼吸道真菌病的患病率有所增加。多烯类抗真菌药物在这些疾病的治疗中发挥着关键作用，其中两性霉素 B (AmB) 是最具代表性的药物。本研究旨在评估局部给药 AmB 治疗呼吸道真菌感染的有效性和安全性。我们对 2014 年 1 月至 2023 年 6 月期间接受局部 AmB 治疗呼吸道真菌感染的住院患者进行了回顾性研究。收集并分析了 36 例接受局部 AmB 治疗的侵袭性肺部真菌感染患者的数据。 27 名患者接受了雾化治疗。治疗后，17名患者病情有所改善，而10名患者没有反应并在医院死亡。一名患者出现了刺激性咳嗽的不良反应。 7 名患者接受了气管镜灌注，2 名患者接受了胸腔内冲洗；取得了良好的临床治疗效果，且无不良反应。全身抗真菌治疗与AmB局部给药联合应用，疗效良好，患者耐受性良好。密切监测常规血液检查、肝肾功能以及电解质、肌钙蛋白和 B 型利钠肽水平支持了这一结论。