A Review on the Clinical Use of Inhaled Amphotericin B

Kuiper, Laura; Ruijgrok, Elisabeth J.

doi:10.1089/jamp.2008.0715

Cited by 56 publications

(54 citation statements)

References 77 publications

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“…Therefore, for the agents used for prophylaxis or treatment of infection confined to the airspace, concentrations in epithelial lining fluid (ELF) and within pulmonary alveolar macrophages are of direct importance. The inhalation of aerosolized amphotericin B formulations is a potential option for prophylaxis (133,134,135). Antifungal drug concentrations within ELF after aerosol inhalation or systemic administration were recently reviewed (12).…”

Section: Lungmentioning

confidence: 99%

Tissue Penetration of Antifungal Agents

Troke²,

2014

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SUMMARY Understanding the tissue penetration of systemically administered antifungal agents is critical for a proper appreciation of their antifungal efficacy in animals and humans. Both the time course of an antifungal drug and its absolute concentrations within tissues may differ significantly from those observed in the bloodstream. In addition, tissue concentrations must also be interpreted within the context of the pathogenesis of the various invasive fungal infections, which differ significantly. There are major technical obstacles to the estimation of concentrations of antifungal agents in various tissue subcompartments, yet these agents, even those within the same class, may exhibit markedly different tissue distributions. This review explores these issues and provides a summary of tissue concentrations of 11 currently licensed systemic antifungal agents. It also explores the therapeutic implications of their distribution at various sites of infection.

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Section: Lungmentioning

confidence: 99%

Tissue Penetration of Antifungal Agents

Troke²,

2014

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“…use) including water-soluble lyophilised amphotericin deoxycholate and three commercially available lipid preparations; and, finally, by a substantial diversity of the diseases for which these agents have been nebulised. A variety of nebulisation devices can deliver amphotericin B particles with good tolerability to the lower respiratory tract in doses capable of exceeding typical Aspergillus minimal inhibitory concentrations in the epithelial lining fluid [111]. Systemic levels are low, reducing the risk of renal and other toxicities.…”

Section: Alternatives To Azolesmentioning

confidence: 99%

Treatment options in severe fungal asthma and allergic bronchopulmonary aspergillosis

Moss

2013

Eur Respir J

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Severe asthma with fungal sensitisation and allergic bronchopulmonary aspergillosis encompass two closely related subgroups of patients with severe allergic asthma. Pulmonary disease is due to pronounced host inflammatory responses to noninvasive subclinical endobronchial infection with filamentous fungi, usually Aspergillus fumigatus. These patients usually do not achieve satisfactory disease control with conventional treatment of severe asthma, i.e. high-dose inhaled corticosteroids and long-acting bronchodilators. Although prolonged systemic corticosteroids are effective, they carry a substantial toxicity profile. Supplementary or alternative therapies have primarily focused on use of antifungal agents including oral triazoles and inhaled amphotericin B. Immunomodulation with omalizumab, a humanised anti-IgE monoclonal antibody, or "pulse" monthly high-dose intravenous corticosteroid, has also been employed. This article considers the experience with these approaches, with emphasis on recent clinical trials. @ERSpublications Treatment of fungal asthma includes glucocorticoids, azoles, amphotericin and anti-IgE. Trial validation is needed.

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“…Unfortunately, the literature on inhaled amphotericin is confused by a plethora of delivery systems and dose regimes, availability of multiple intravenous formulations (watersoluble lyophilized amphotericin deoxycholate and three commercially available lipid-based preparations), and the diversity of patients and diseases treated. Amphotericin B can be administered by jet nebulization to airways with good tolerability at doses capable of killing Aspergillus in the epithelial lining fluid without the toxicity of parenteral administration [62 ]. One dose regime reported able to do this is 20 mg amphotericin deoxycholate nebulized b.i.d.…”

Section: Treatmentmentioning

confidence: 99%

Allergic bronchopulmonary aspergillosis and Aspergillus infection in cystic fibrosis

Moss

2010

Current Opinion in Pulmonary Medicine

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Diagnosis of CF-ABPA remains difficult, but improvements in serologic assays are occurring. Treatment remains in many cases unsatisfactory, and new agents offer promise but await proper controlled trials of safety and efficacy. A. fumigatus airway infection and A. fumigatus allergy without ABPA are emerging as further complications of A. fumigatus respiratory colonization in patients with CF, but prospective studies are needed to corroborate largely retrospective findings.

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A Review on the Clinical Use of Inhaled Amphotericin B

Cited by 56 publications

References 77 publications

Tissue Penetration of Antifungal Agents

Tissue Penetration of Antifungal Agents

Treatment options in severe fungal asthma and allergic bronchopulmonary aspergillosis

Allergic bronchopulmonary aspergillosis and Aspergillus infection in cystic fibrosis

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