Successful Treatment of Rhinocerebral Mucormycosis with Liposomal Amphotericin B and Surgery in Two Diabetic Patients with Renal Dysfunction

Kofteridis, Diamantis P.; Karabekios, S.; Panagiotides, J.G.; Bizakis, John G.; Kyrmizakis, Dionysios E.; Saridaki, Zenia; Gikas, Aristofanis

doi:10.1179/joc.2003.15.3.282

Cited by 17 publications

(11 citation statements)

References 15 publications

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“…The highest number of clinical failures relate to infections caused by Cunninghamella bertholletiae , which supports the high AmB MICs reported for this Zygomycete [2,21–25]. However, several series and case reports describing successful treatment with this drug have been published [26–37]. A number of retrospective studies have reported an increase in survival rates when lipid formulations of AmB were used as first‐line or salvage therapy, primarily liposomal AmB (L‐AmB) [26–33].…”

Section: Antifungal Susceptibility Profile Of Zygomycetesmentioning

confidence: 86%

“…However, several series and case reports describing successful treatment with this drug have been published [26–37]. A number of retrospective studies have reported an increase in survival rates when lipid formulations of AmB were used as first‐line or salvage therapy, primarily liposomal AmB (L‐AmB) [26–33]. As these formulations are more effective and better tolerated, they have replaced conventional AmB in the treatment of these infections.…”

Section: Antifungal Susceptibility Profile Of Zygomycetesmentioning

confidence: 99%

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In vitro activity of antifungals against Zygomycetes

Alastruey‐Izquierdo

Castelli

Cuesta

et al. 2009

Clinical Microbiology and Infection

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To date, no reference standard for therapy for zygomycosis has been established because there are insufficient clinical data with which to make such a judgement. Knowledge of the species responsible for the infection and its antifungal susceptibility profile has become increasingly important in the management of patients. Amphotericin B is the most active drug against all the species involved, followed by posaconazole, whereas voriconazole has no activity. Echinocandins are completely inactive in vitro, but may be an interesting option when used in combination with other drugs.

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Section: Antifungal Susceptibility Profile Of Zygomycetesmentioning

confidence: 86%

Section: Antifungal Susceptibility Profile Of Zygomycetesmentioning

confidence: 99%

In vitro activity of antifungals against Zygomycetes

Alastruey‐Izquierdo

Castelli

Cuesta

et al. 2009

Clinical Microbiology and Infection

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“…This includes reducing the predisposing factors of the patient, surgical debridement and application of antifungal therapy. Amphotericin B, especially new lipid formulations, is still the agent of choice, and data exist that suggest a combinational therapy with posaconazole as promising 85,109,110,111,112,113…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of Invasive Fungal Infections in the Mediterranean Area

Binder¹,

Lass‐Flörl²

2011

Mediterr J Hematol Infect Dis

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Although Candida species remain the relevant cause of IFI, other fungi (especially moulds) have become increasingly prevalent. In particular, Aspergillus species are the leading cause of mould infections but also Glomeromycota (formerly Zygomycetes) and Fusarium species are increasing in frequency, and are associated with high mortality rates. Many of these emerging infections occur as breakthrough infections in patients treated with new antifungal drugs. The causative pathogens, incidence rate and severity are dependent on the underlying condition, as well as on the geographic location of the patient population. France and Italy show the highest incident rates of Fusarium infections in Europe, following the US, where numbers are still increasing. Scedosporium prolificans, which primarily is found in soil in Spain and Australia, is most frequently isolated from blood cultures in a Spanish hospital. Geotrichum capitatum represents another species predominantly found in Europe with especially high rates in Mediterranean countries. The increasing resistance to antifungal drugs especially of these new emerging pathogens is a severe problem for managing these IFIs.

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“…Their efficacy appears to be comparable to or better than that of AmB deoxycholate [8]. These lipid formulations of AmB have been used in the treatment of zygomycosis with consistently successful outcomes [43,44,49–53] and therefore are considered as drugs of choice for this disease [52]. AmB lipid formulations should be used at a dose starting at 3–5 mg/kg/day, although higher doses will be needed occasionally.…”

Section: Antifungal Therapy With Amb Formulationsmentioning

confidence: 99%

“…[55]. Since then, several other case reports and reviews [9,34,39,49,56–65] have supported the use of L‐AmB as a first‐line agent for the treatment of zygomycosis. A review of 120 cases of zygomycosis in patients with haematological malignancies found a survival rate of 67% (10/16) in patients treated with L‐AmB compared with 39% (24/62) in those treated with AmB deoxycholate (p =0.02) [64].…”

mentioning

confidence: 99%

Lipid formulations of amphotericin B as first-line treatment of zygomycosis

Πετρίκκος

2009

Clinical Microbiology and Infection

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Zygomycosis is a difficult to treat and frequently fatal infection affecting immunocompromised and, rarely, immunocompetent patients. The early diagnosis and immediate initiation of treatment with an antifungal agent in combination with surgical intervention has proved critical for the favourable outcome of the disease. Few antifungal agents are available for treatment. Amphotericin B (AmB) deoxycholate has been the drug of choice for many years and is usually given at high daily doses which can result in renal toxicity. Currently, lipid formulations of AmB (liposomal AmB (L-AmB), AmB lipid complex (ABLC), AmB colloidal dispersion (ABCD)), mainly L-AmB, rather than conventional AmB have become the standard therapy. The rationale behind the use of lipid formulations is that they decrease the nephrotoxicity associated with longterm AmB use. Although there is a developing consensus that high doses of lipid formulations of AmB should be the antifungal therapy of choice for all patients with zygomycosis, until now there have been no data available with which to define the appropriate dose. The duration of therapy remains an unresolved issue, regarding both lipid formulations of AmB as well as sequential or combination treatments consisting of lipid formulations of AmB with posaconazole, a drug which has now emerged as a new therapeutic option.

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Successful Treatment of Rhinocerebral Mucormycosis with Liposomal Amphotericin B and Surgery in Two Diabetic Patients with Renal Dysfunction

Cited by 17 publications

References 15 publications

In vitro activity of antifungals against Zygomycetes

In vitro activity of antifungals against Zygomycetes

Epidemiology of Invasive Fungal Infections in the Mediterranean Area

Lipid formulations of amphotericin B as first-line treatment of zygomycosis

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