Efficacy and safety of Amphotericin B Lipid Complex Injection (ABLC) in solid‐organ transplant recipients with invasive fungal infections

Linden, Peter K.; Williams, Penny; Chan, Kevin M.

doi:10.1034/j.1399-0012.2000.140409.x

Cited by 54 publications

(5 citation statements)

References 65 publications

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“…Our pooled analysis showed that fever occurred in one-third to one-half of patients receiving AmB, ABLC, and ABCD, which is consistent with previous reports [5,71]. On the basis of similar definitions, our findings regarding nephrotoxicity were also similar to findings in other analyses [5,8,71,72].…”

Section: Discussionsupporting

confidence: 82%

“…Although available commercially outside of the USA for several years, a third product, liposomal AmB, or LAmB (AmBisome; NeXstar Pharmaceuticals/Fujisawa, San Dimas, CA, USA), received FDA approval in 1997. A majority of patients receiving these newer formulations have demonstrated intolerance to AmB or are documented to have Aspergillus infections refractory to AmB conventional therapy [3,[6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

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Adverse effects of antifungal therapies in invasive fungal infections: review and meta-analysis

Girois

Chapuis

Decullier

et al. 2006

Eur J Clin Microbiol Infect Dis

121

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Amphotericin B is the main therapeutic agent for the treatment of invasive fungal infections; however, it is associated with significant toxicities that limit its use. Other systemic antifungal agents have been developed to improve tolerability while maintaining the efficacy profile of conventional amphotericin B. Fifty-four studies involving 9,228 patients were assessed for the frequency of adverse effects of the main systemic antifungal agents. While the results suggest that liposomal amphotericin B is the least nephrotoxic of the lipid formulations (14.6%), that conventional amphotericin B is the most nephrotoxic (33.2%), and that itraconazole is the most hepatotoxic (31.5%), the lack of standard definitions of antifungalrelated adverse effects limits the validity of these results. Furthermore, heterogeneous patient pools and differing protocols make it difficult to draw direct comparisons between studies. With the advent of newer classes of systemic antifungal agents, future trials should conform to definitions that are universally applicable and clinically relevant to allow for such comparisons and to enable evidence-based decision-making.

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Adverse effects of antifungal therapies in invasive fungal infections: review and meta-analysis

Girois

Chapuis

Decullier

et al. 2006

Eur J Clin Microbiol Infect Dis

121

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“…Many experts choose lipid amphotericin B for patients with underlying kidney disease and for those at increased risk of developing nephrotoxicity. However, support for its use in blastomycosis comes from animal models and anecdotal clinical experience (27,29,31,34,75,93,99).…”

Section: Treatment Treatment Optionsmentioning

confidence: 99%

Clinical and Laboratory Update on Blastomycosis

2010

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SUMMARY Blastomycosis is endemic in regions of North America that border the Great Lakes and the St. Lawrence River, as well as in the Mississippi River and Ohio River basins. Men are affected more often than women and children because men are more likely to participate in activities that put them at risk for exposure to Blastomyces dermatitidis. Human infection occurs when soil containing microfoci of mycelia is disturbed and airborne conidia are inhaled. If natural defenses in the alveoli fail to contain the infection, lymphohematogenous dissemination ensues. Normal host responses generate a characteristic pyogranulomatous reaction. The most common sites of clinical disease are the lung and skin; osseous, genitourinary, and central nervous system manifestations follow in decreasing order of frequency. Blastomycosis is one of the great mimickers in medicine; verrucous cutaneous blastomycosis resembles malignancy, and mass-like lung opacities due to B. dermatitidis often are confused with cancer. Blastomycosis may be clinically indistinguishable from tuberculosis. Diagnosis is based on culture and direct visualization of round, multinucleated yeast forms that produce daughter cells from a single broad-based bud. Although a long course of amphotericin B is usually curative, itraconazole is also highly effective and is the mainstay of therapy for most patients with blastomycosis.

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“…VC and CAS showed very high MIC 90 s, 8 to 16 g/ml and 128 to Ͼ256 g/ml, respectively. AMB has traditionally been the treatment of choice for zygomycosis (1,2,4,12,18,24). The limited clinical use of ITC in the treatment of zygomycosis does not allow us to draw any conclusions from the in vitro data (8,15,17).…”

mentioning

confidence: 99%

In Vitro Activities of Amphotericin B, Caspofungin, Itraconazole, Posaconazole, and Voriconazole against 45 Clinical Isolates of Zygomycetes: Comparison of CLSI M38-A, Sensititre YeastOne, and the Etest

Torres-Narbona

Guinea

Martínez-Alarcón

et al. 2007

Antimicrob Agents Chemother

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We evaluated the activities of amphotericin B, itraconazole, voriconazole, caspofungin, and posaconazole against zygomycetes by CLSI M38-A, Etest and Sensititre. The most active drug was posaconazole, followed by amphotericin B and itraconazole. The correlation of the Etest and Sensititre with CLSI M38-A was moderate for posaconazole but poor for the others.The incidence of zygomycosis is increasing in some institutions, purportedly due to voriconazole prophylaxis (16,19,20,22,23,25,28,31,32). The introduction of new antifungal agents and the availability of alternative antifungal susceptibility procedures necessitate studies comparing the in vitro activity of these new antifungal agents against zygomycetes.In this study, the in vitro activities of amphotericin B (AMB), itraconazole (ITC), voriconazole (VC), caspofungin (CAS), and posaconazole (POS) were assessed against 45 clinical strains of zygomycetes (Table 1). In addition, we compared the results obtained by the CLSI M38-A method with the Etest and Sensititre YeastOne.CLSI M38-A method. The antifungal drugs used were AMB (Sigma Chemical Co., St. Louis, MO), ITC (Janssen Pharmaceutical Research and Development, Madrid, Spain), VC (Pfizer Pharmaceutical Group, New York, NY), POS (ScheringPlough, Kenilworth, NJ), and CAS (Merck Research Laboratories, Rahway, NJ). The broth microdilution method was performed according to CLSI guidelines (21). The final concentration of the VC, ITC, POS, and AMB in the wells ranged from 0.03 to 16 g/ml. The final concentration of CAS in the wells ranged from 0.250 to 256 g/ml. The MIC endpoint was defined as the lowest concentration producing complete inhibition of growth (MIC-0) for all the antifungal drugs studied. The minimum effective concentration (MEC) endpoint for CAS was defined as the lowest concentration at which an abnormal growth was observed.Quality control was ensured by testing Aspergillus flavus ATCC 204304 and Aspergillus fumigatus ATCC 204305. All results were within the recommended limits of CLSI M38-A.Etest and Sensititre YeastOne procedures. Etest strips (AB Biodisk, Solna, Sweden) of ITC, VC, CAS, and AMB were supplied by Tec Laim (Madrid, Spain), and those of POS were supplied by Schering-Plough (Kenilworth, NJ). Inoculum suspensions were prepared in the same way as for the CLSI method. The MIC was defined as the lowest drug concentration at which the border of the elliptical inhibition zone intercepted the scale on the antifungal strip.The activities of AMB, VC, ITC, and CAS were studied by means of Sensititre YeastOne (Trek Diagnostic Systems, Ltd., East Grinstead, United Kingdom). The trays containing serial twofold dilutions of the drug (0.008 to 16 g/ml) were used. Inoculum suspensions were prepared in the same way as for the CLSI method, and the adjusted suspensions were diluted at 1:100 in RPMI.The CLSI microtiter panels, Sensititre panels, and Etest plates were incubated at 35°C and read after 16,24, 36, 48, and 72 h of incubation.We compared CLSI M38-A results (incubation at 24 h) with the altern...

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Efficacy and safety of Amphotericin B Lipid Complex Injection (ABLC) in solid‐organ transplant recipients with invasive fungal infections

Abstract: ABLC is safe and effective treatment for fungal infections in solid-organ transplant recipients. Its renal-sparing properties are particularly suited for this high-risk population for renal failure.

Cited by 54 publications

References 65 publications

Adverse effects of antifungal therapies in invasive fungal infections: review and meta-analysis

Adverse effects of antifungal therapies in invasive fungal infections: review and meta-analysis

Clinical and Laboratory Update on Blastomycosis

In Vitro Activities of Amphotericin B, Caspofungin, Itraconazole, Posaconazole, and Voriconazole against 45 Clinical Isolates of Zygomycetes: Comparison of CLSI M38-A, Sensititre YeastOne, and the Etest

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