Use of nebulised liposomal amphotericin B in the treatment of Aspergillus fumigatus empyema.

Purcell, Ian; Corris, Paul

doi:10.1136/thx.50.12.1321

Cited by 41 publications

(25 citation statements)

References 7 publications

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“…Two different experimental studies have been published on the effect of prophylaxis of pulmonary aspergillosis with aerosolized AmBisome (1) or Abelcet (8), both of which were found to be highly protective. Whether this route of administration of AMB-lipid formulations will be well tolerated and will be effective in human patients is not known, as only one report on the use of nebulized AmBisome in a single patient has been published (22).…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Liposomal Amphotericin B with Prolonged Circulation in Blood in Treatment of Severe Pulmonary Aspergillosis in Leukopenic Rats

Etten

Stearne-Cullen

Kate

et al. 2000

Antimicrob Agents Chemother

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The therapeutic efficacy of long-circulating polyethylene glycol-coated liposomal amphotericin B (AMB) (PEG-AMB-LIP) was compared with that of AMB desoxycholate (Fungizone) in a model of severe invasive pulmonary aspergillosis in persistently leukopenic rats as well as in temporarily leukopenic rats. PEG-AMB-LIP treatment (intravenous administration) consisted of a single, or double (every 72 h), or triple (every 72 h) dose of 10 mg of AMB/kg of body weight, a double dose (every 72 h) of 14 mg of AMB/kg, or a 5-day treatment (every 24 h) with 6 mg/kg/dose. AMB desoxycholate was administered for 10 consecutive days at 1 mg of AMB/kg/dose. Treatment was started 30 h after fungal inoculation, at which time mycelial growth was firmly established. Both persistently and temporarily leukopenic rats died between 4 and 9 days after Aspergillus fumigatus inoculation when they were left untreated or after treatment with a placebo. In persistently leukopenic rats, a single dose of PEG-AMB-LIP (10 mg/kg) was as effective as the 10-day treatment with AMB desoxycholate (at 1 mg/kg/dose) in significantly prolonging the survival of rats infected with A. fumigatus and in reducing the dissemination of A. fumigatus to the liver. Prolongation of PEG-AMB-LIP treatment (double or triple dose or 5-day treatment) did not further improve efficacy. For temporarily leukopenic rats no major advances in efficacy were achieved compared to those for persistently leukopenic rats, probably because the leukocyte numbers in blood were restored too late in the course of infection.

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Section: Discussionmentioning

confidence: 99%

Efficacy of Liposomal Amphotericin B with Prolonged Circulation in Blood in Treatment of Severe Pulmonary Aspergillosis in Leukopenic Rats

Etten

Stearne-Cullen

Kate

et al. 2000

Antimicrob Agents Chemother

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“…Clinical features of pulmonary aspergillosis include allergic bronchitis, aspergilloma, in which a mycelial mass lies in a previously formed cavity or congenital cyst, and necrotizing bronchopeumonia. 5 The three cases reported in this paper, however, displayed unique clinical features, such a Fig. Bullae are the preferred site for Aspergillus, 4 and according to some reports, this may lead to pneumothorax or empyema, which is called pleural aspergillosis.…”

Section: Discussionmentioning

confidence: 77%

Late pleuropulmonary aspergillosis after the treatment of pneumothorax: Report of three cases

et al. 1999

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A bullectomy for spontaneous pneumothorax is often combined with pleurodesis to prevent recurrence. A recurrent or progressive residual bullous lung beneath adhesive pleura neovascularized from the chest wall may be affected by aspergillosis. Of the 12 patients with pulmonary aspergillosis secondary to bullous lung disease treated surgically at our hospital since 1974, 3 underwent a bullectomy with pleurodesis for spontaneous pneumothorax. The presenting symptoms in all cases were hemosputum. Aspergillus lesions affected the patients in the right upper lobe, the left apical segment, and both apical segments at 16, 9, and 13 years, respectively, after a bullectomy. Angiograms demonstrated hypervascularization in the intercostal and internal thoracic arteries, as well as in the bronchial branches. Catheter embolization for airway bleeding was not effective in 1 patient. Four operations, including an emergency procedure for massive intrapulmonary bleeding, were performed. These included a right upper lobectomy followed by a left upper segmentectomy at second-look operation in 1 patient who required bilateral chest wall resections. All patients survived the operations. Intraoperative bleeding ranged between 700 and 3 500 ml (1 543 ml on average), and bleeding foci were mainly from the chest wall, with hypervascularization stemming from the ipsilateral chest wall. Postoperative complications included pleural space hemorrhaging and a bronchopleural fistula, both of which required additional chest wall resections. Patients with bullous lung disease late after a bullectomy with pleurodesis may thus be associated with complex pleuropulmonary aspergillosis, which requires surgical therapy concomitant with a chest wall resection.

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“…There are also sporadic reports of the use of aerosolized lipid-based amphotericin B products to treat refractory invasive aspergillosis or zygomycosis; however, no randomized, controlled studies are yet available [56,57]. Data are limited regarding inhalation of other antifungals.…”

Section: Aerosolized Antifungalsmentioning

confidence: 97%

Inhaled antimicrobial therapies for respiratory infections

Kim¹,

Kuti²,

Nicolau

2008

Curr Infect Dis Rep

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Inhaled antimicrobial therapy is attractive because of its potential to provide high concentrations of antimicrobials to the site of active respiratory infections while avoiding systemic toxicity. Many antimicrobials have been used in inhaled preparations, including aminoglycosides, colistin sodium, cephalosporins, penicillins, vancomycin, amphotericin B, and several antiviral compounds. This review highlights available data on inhaled antimicrobials, antifungals, and antivirals for the prevention and treatment of infections of the respiratory tract.

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Use of nebulised liposomal amphotericin B in the treatment of Aspergillus fumigatus empyema.

Cited by 41 publications

References 7 publications

Efficacy of Liposomal Amphotericin B with Prolonged Circulation in Blood in Treatment of Severe Pulmonary Aspergillosis in Leukopenic Rats

Efficacy of Liposomal Amphotericin B with Prolonged Circulation in Blood in Treatment of Severe Pulmonary Aspergillosis in Leukopenic Rats

Late pleuropulmonary aspergillosis after the treatment of pneumothorax: Report of three cases

Inhaled antimicrobial therapies for respiratory infections

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