Mortality and Costs of Acute Renal Failure Associated with Amphotericin B Therapy

Bates, David W.; Su, L. Joseph; Yu, Dong; Chertow, Glenn M.; Seger, Diane L.; Gomes, Daniel; Dasbach, Erik J.; Platt, Richard

doi:10.1086/319211

Cited by 402 publications

(288 citation statements)

References 40 publications

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“…Until recently, chemotherapeutic options for the treatment of invasive candidiasis included agents associated with significant toxicity (1,2,3,10) or which lacked activity against the full spectrum of Candida species (4,11,19). In addition, the relatively constant attributable mortality rate of 30 to 40% associated with invasive candidiasis and candidemia is a major concern (7,17,18).…”

Section: Discussionmentioning

confidence: 99%

Phase 2, Randomized, Dose-Ranging Study Evaluating the Safety and Efficacy of Anidulafungin in Invasive Candidiasis and Candidemia

Krause¹,

Reinhardt

Vázquez

et al. 2004

Antimicrob Agents Chemother

164

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This study evaluated the safety and efficacy of anidulafungin, a novel echinocandin, in patients with invasive candidiasis, including candidemia. A total of 123 eligible patients were randomized to one of three intravenous regimens, 50, 75, or 100 mg once daily. Treatment continued for 2 weeks beyond resolution or improvement of signs and symptoms. The primary efficacy criterion was a successful global response rate (i.e., clinical and microbiological success) in the evaluable population at the follow-up (FU) visit, 2 weeks after end of therapy (EOT). One hundred twenty (120) patients received at least one dose of anidulafungin; 68 were evaluable. Review of adverse events and laboratory data indicated no dose response for safety parameters. Non-albicans Candida species accounted for approximately one-half of all isolates. Success rates at EOT were 84, 90, and 89% in the 50-, 75-, and 100-mg groups, respectively. At FU, the success rates were 72, 85, and 83%. Phase 3 studies of anidulafungin for the treatment of invasive candidiasis and candidemia are warranted.

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Section: Discussionmentioning

confidence: 99%

Phase 2, Randomized, Dose-Ranging Study Evaluating the Safety and Efficacy of Anidulafungin in Invasive Candidiasis and Candidemia

Krause¹,

Reinhardt

Vázquez

et al. 2004

Antimicrob Agents Chemother

164

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show abstract

“…Nephrotoxicity associated with amphotericin B has been shown in several data sets to contribute to increases in mortality, longer hospitalisations and markedly increased hospital costs. Reports suggest 2.7- to 6-fold increase in the odds of death following the occurrence of amphotericin B-associated nephrotoxicity (Bates et al 2001; Harbarth et al 2002; Chen et al 2006). Among the pooled studies included in our meta-analysis, the incidence of nephrotoxicity was approximately three times higher (26.6% vs. 8%) in the amphotericin B treatment groups when compared to triazoles (Figure 4).…”

Section: Discussionmentioning

confidence: 99%

Fungicidal versus fungistatic therapy of invasive Candida infection in non-neutropenic adults: a meta-analysis

et al. 2018

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The purpose of this study was to determine whether fungicidal versus fungistatic pharmacotherapy of invasive candidiasis/candidemia yields superior outcomes.Data sources included MEDLINE (1966–June 2017), EMBASE (1980–June 2017), PubMed (1966–June 2017), Global Health-Ovid (inception to June 2017), LILACS Virtual Health Library (inception to June 2017) and the Cochrane Central Register of Controlled Trials (to 2nd quarter 2017). The ClinicalTrial.gov database, the SCOPUS database, SIGLE (System for Information on Grey Literature) and Google Scholar were also utilised to search for relevant studies.Randomised studies of any pharmacotherapy of invasive candidiasis including candidemia using a fungicidal (amphotericin B or echinocandin compound) versus a fungistatic (triazole) compound in adolescent or adult non-neutropenic patients. Eight studies met the inclusion criteria.Pooled odds ratios demonstrated an advantage of fungicidal therapy with respect to early therapeutic success (OR 1.61, 95% CI 1.27–2.03, p < 0.0001, I2 = 0%) and persistence or recurrence of infection (OR 0.51, 95% CI 0.35–0.74, p = 0.0005, I2 = 0%) but no advantage for late survival (OR 0.97, 95% CI 0.77–1.21, p = 0.77, I2 = 0%).Fungicidal therapy of invasive candidiasis and candidemia is associated with a higher probability of early therapeutic success and decreased probability of persistent or recurrent infection. However, there is no improvement in survival.

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“…This reduction in empiric antifungal therapy is less likely to be beneficial in autologous HSCT where the risk of nephrotoxicity and its associated morbidity is not as great as in allogeneic HSCT. 18,19 Two earlier studies of pre-emptive intravenous therapy in adults undergoing SCT undertaken in the early 1990s and late 1980s suggested a reduced incidence of BSI 1 and fever. 2 However, these trials were either not randomized 2 or included other interventions such as the use of laminar air-flow ventilation or the use of systemic non-absorbable antibiotics.…”

Section: Discussionmentioning

confidence: 99%

A randomized comparison of empiric or pre-emptive antibiotic therapy after hematopoietic stem cell transplantation

Slavin

Grigg

Schwarer

et al. 2007

Bone Marrow Transplant

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We performed a randomized comparison of pre-emptive and empiric antibiotic therapy for adult patients undergoing allogeneic or autologous stem cell transplantation. One hundred and fifty-three patients were randomized to receive cefepime either pre-emptively on the day that neutropenia (ANCo1.0 Â 10 9 cells/l) developed irrespective of the presence of fever, or at onset of fever and neutropenia (empiric). Although there was no difference between the two arms in the proportion of patients developing fever or in the median number of days of fever, the time to onset of fever was a mean of 1 day longer in each patient on the pre-emptive arm (log rank Po0.001). The number of patients with bloodstream infections was significantly reduced in those receiving pre-emptive therapy (16/75) compared to the empiric arm (31/76) (Po0.01) but this did not translate into an appreciable clinical benefit as measured by days of hospitalization, time to engraftment, use of additional antimicrobial agents or mortality at 30 days. This study does not support the use of pre-emptive intravenous antibiotic therapy in adult stem cell transplant recipients.

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Mortality and Costs of Acute Renal Failure Associated with Amphotericin B Therapy

Cited by 402 publications

References 40 publications

Phase 2, Randomized, Dose-Ranging Study Evaluating the Safety and Efficacy of Anidulafungin in Invasive Candidiasis and Candidemia

Phase 2, Randomized, Dose-Ranging Study Evaluating the Safety and Efficacy of Anidulafungin in Invasive Candidiasis and Candidemia

Fungicidal versus fungistatic therapy of invasive Candida infection in non-neutropenic adults: a meta-analysis

A randomized comparison of empiric or pre-emptive antibiotic therapy after hematopoietic stem cell transplantation

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