Safety of aerosolized liposomal versus deoxycholate amphotericin B formulations for prevention of invasive fungal infections following lung transplantation: a retrospective study

Abstract

In lung transplant recipients, both inhaled AmBd and L-AmB were safe and well tolerated over a large number of medication exposures.

Nebulized Liposomal Amphotericin B Prophylaxis for Aspergillus Infection in Lung Transplantation: Pharmacokinetics and Safety

“…16 Other formulations of inhaled amphotericin B (lipid complex and liposomal amphotericin) have been proposed for prophylactic purposes, with promising results. [17][18][19][20] In some experimental models, nebulized liposomal amphotericin B (n-LAB) has been shown to be more effective 21 and long-lasting 22 than the conventional formulation.…”

Physicochemical Properties and Antifungal Activity of Amphotericin B Incorporated in Cholesteryl Carbonate Esters

“…As such, a lipid-based system was sought that would provide enhanced biological activity and is readily amenable for development as a formulation in a dry powder inhaler. Such an approach would extend earlier work wherein AmB was being successfully delivered to the lung as nebulized dosage form, [8][9][10] and liposomal AmB was developed as a dry powder inhaler. 11 In these studies, lung delivery provided targeted therapy at the infected area, and reduced the exposure of AmB to other tissues susceptible to toxicity, for example, kidney.…”

“…Additionally, with improved efficacy and tolerability, inhalation of AmB can be used prophylactically against Aspergillus infection following lung transplantation. [8][9][10] For this goal, thermotropic liquid crystalline (LC) phases were considered because it appeared that such structures were associated with enhanced AmB biological activity. In addition, many naturally occurring lipids form LCs and have been used in pharmaceutical applications.…”

Inhaled antimicrobial therapies for respiratory infections

“…In one double-blind study, treatment-limiting adverse events occurred in 12.2% and 5.9% of patients receiving conventional amphotericin B deoxycholate and lipid complex amphotericin B (ABLC), respectively [52••]. However, a retrospective comparison of patients receiving aerosolized liposomal amphotericin B or conventional amphotericin B found adverse events in approximately 1% of patients in both groups [54]. ABLC was also well tolerated in patients with allogeneic HSCT after 13 weeks of aerosolized treatment [55•].…”