Amphotericin B Lipid Complex Compared with Amphotericin B in the Treatment of Cryptococcal Meningitis in Patients with AIDS

Sharkey, P. K.; Graybill, John R.; Johnson, Edward S.; Hausrath, S. G.; Pollard, Richard B.; Kolokathis, Antonia; Mildvan, Donna; Fan-Havard, Patty; Eng, Robert H. K.; Patterson, Thomas F.; Pottage, John C.; Simberkoff, Michael S.; Wolf, Judith K.; Meyer, Richard D.; Gupta, Renu; Lee, Lily W.; Gordon, David S.

doi:10.1093/clinids/22.2.315

Cited by 177 publications

(91 citation statements)

References 10 publications

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“…Electrolyte disturbances may be exacerbated by co-administration of thiazides and loop diuretics. Toxicity appears to be reduced for the lipid formulations (liposomal amphotericin B and amphotericin B lipid complex) [51][52][53]. These formulations do not appear to be more toxic in elderly patients than in younger patients and efficacy appears to be similar [54,55].…”

Section: Amphotericin Bmentioning

confidence: 97%

Strategies to Improve Medication Adherence in Older Persons: Consensus Statement from the Senior Italia Federanziani Advisory Board

et al. 2016

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Candida infections in the elderly are an important and expanding clinical problem, with significantly higher mortality in this group than in younger patients. The increasing problem of invasive Candida infections may be related to higher prevalence of immunocompromised older people and the emergence of treatment resistance. Older people, especially the frail and critically ill, are at higher risk of medication-related harmful effects due to changes in pharmacokinetics and pharmacodynamics, which may be further complicated by organ dysfunction, diminished homeostatic control, co-morbidities and polypharmacy. Here, we review the available options for the treatment of Candida infections and provide insights into the challenges surrounding the optimal use of antifungal drugs in the elderly. Key PointsCandida infections are a growing problem in elderly patients, with significant mortality in this group.Treatment in the elderly requires careful consideration of benefit and harm in the selection of both the drug and dose regimen.Therapeutic drug monitoring can be recommended for selected antifungal agents.

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Section: Amphotericin Bmentioning

confidence: 97%

Strategies to Improve Medication Adherence in Older Persons: Consensus Statement from the Senior Italia Federanziani Advisory Board

et al. 2016

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“…However, many patients in the latter group maintained positive culture for cryptococcus at the end of the treatment. (26) In uncontrolled studies of patients with opportunistic infections, ABLC showed an efficacy of 42%, 67% and 100% in aspergillosis cases, of 66%, 67% and 100% in candidiasis cases, of 71% in zygomycosis cases, and of 82% in fusariosis cases. (27)(28)(29) …”

Section: Amphotericin B Lipid Complexmentioning

confidence: 99%

“…With the exception of histoplasmosis, in which liposomal amphotericin B has been shown to provide a greater percentage of favorable responses, (47) the efficacy of the new formulations is similar to that of conventional amphotericin B in patients with cryptococosis, (17,26) candidiasis, (10) aspergillosis, (23) or (empirical treatment of) neutropenia with persistent fever. (16,22) Notwithstanding these observations, it is accepted that one of the indications for the use of lipid preparations is presumed failure of amphotericin B desoxycholate treatment, using the criterion of the lack of a favorable response after an accumulated dose of 500 mg. (48) In that case, it is supposed that the fungus is susceptible and, especially in the empirical treatment of immunosuppressed patients, daily doses greater than those recommended for conventional amphotericin B but within the therapeutic range recommended for L-Amb, ABCD and ABLC, are used.…”

Section: Clinical Use Of New Antifungal Agents Lipid Formulations Of mentioning

confidence: 99%

Atualização no uso de agentes antifúngicos

Martínez

2006

J. bras. pneumol.

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We summarize here data regarding the spectrum of action, the pharmacological aspects, the toxicological aspects and the clinical efficacy of liposomal amphotericin B, amphotericin B in colloidal dispersion, amphotericin B lipid complex, voriconazole and caspofungin. We discuss the use of these more recently introduced antifungal agents in terms of their safety, efficiency and cost. We also offer suggestions for the clinical use of these drugs in pulmonary and systemic infections, with an emphasis on the lower toxicity of the lipid formulations of amphotericin B in comparison with conventional medications. In addition, we explore the possibility of using voriconazole as the primary treatment for invasive infections such as aspergillosis, as well as those caused by Scedosporium spp. and Fusarium spp., together with that of using caspofungin to treat disseminated candidiasis and invasive aspergillosis.

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“…5FC levels should be monitored, where available, and its dose should be adjusted in renal impairment as drug accumulation increases the risk of bone marrow toxicity (Perfect et al 2010). AmBd-induced anemia is a significant and less well-recognized adverse effect, resulting in a drop in hemoglobin from baseline of 2-3 g/dL (Joly et al 1996;Sharkey et al 1996;Leenders et al 1998;Bicanic et al 2008), which may necessitate transfusion. Adverse effects are reversible on stopping treatment (Bicanic et al 2008).…”

Section: Minimize Drug Toxicitymentioning

confidence: 99%