Liposomal amphotericin B versus the combination of fluconazole and itraconazole as prophylaxis for invasive fungal infections during induction

Mattiuzzi, Gloria; Estey, Elihu H.; Raad, Issam; Giles, Francis J.; Cortes, Jorge; Shen, Yu; Kontoyiannis, Dimitrios P.; Koller, Charles; Munsell, Mark F.; Beran, Miloslav; Kantarjian, Hagop M.

doi:10.1002/cncr.11094

Cited by 71 publications

(45 citation statements)

References 37 publications

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“…However, rates of breakthrough candidemia were similarly low with all treatments (145). Sequential azole-polyene therapy has been reported in studies of humans in the context of breakthrough infections while patients were receiving azole prophylaxis including fluconazole (174) or a combination of fluconazole and itraconazole (123). Neither study was designed to specifically examine the effectiveness of amphotericin B after azole exposure, but success rates of lipid formulations of amphotericin B for candidemia (174) and fevers or pneumonia of unknown origin (123) were similar to those reported for other published studies.…”

Section: (D) Other Combinationsmentioning

confidence: 99%

Combination Antifungal Therapy

Johnson

MacDougall

Ostrosky-Zeichner

et al. 2004

Antimicrob Agents Chemother

491

368

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5 RATIONALEThe availability of new antifungal agents with novel mechanisms of action has stimulated renewed interest in combination antifungal therapies. In particular, and despite the limited clinical data, the high mortality of mold infections and the relatively limited efficacy of current agents have produced significant interest in polyene-, extended-spectrum azole-, and echinocandin-based combinations for these difficult-to-treat infections. With the recent publication of the first large randomized trial of antifungal combination therapy to be conducted in two decades (166) and the rapid proliferation of new in vitro and in vivo data on antifungal combinations, we have sought to review the recent work and future challenges in this area.The focus of this review is on the efficacy of antifungal drugs in combination with respect to the extent or rate of killing of the fungal pathogen, although other potential interactions (such as pharmacokinetic drug interactions) can impact efficacy when these agents are used together. The value of giving two drugs because each is separately effective against a group of organisms exhibiting a variety of types of resistance is not specifically discussed, but this also is an obvious and straightforward reason to use a combination of agents.It cannot be simply assumed that the use of two or more effective drugs with different mechanisms of action will produce an improved outcome compared to the results seen with a single agent. Combination antifungal therapy could reduce antifungal killing and clinical efficacy, increase potential for drug interactions and drug toxicities, and carry a much higher cost for antifungal drug expenditures without proven clinical benefit (106). Thus, it is important to critically evaluate the role of combination therapy as new data become available.Conceptual models and terminology. Methods for studying antifungal combinations in vitro and in vivo have differed considerably over time and among investigators. These tools do not differ with respect to their application to combination antibacterial or antiviral therapies and have been discussed extensively and elegantly in the landmark 1995 review by Greco (79). In brief, all approaches to evaluating combinations can be reduced to two elements: (i) a conceptual model for predicting the expected result for a combination and (ii) a set of phrases used to categorize results that are better than expected, worse than expected, or as expected. Although many subtle variations are possible, the underlying mathematical model is based on either the assumption of additive interactions or the assumption of probabilistic (multiplicative) interactions. On the basis of the terminology employed by the author who first carefully described each of these models, the two models can be usefully referred to as the Loewe additivity model and the Bliss independence model (79).The terminology used to place results into interpretive categories is often the subject of debate and confusion. Greco et al. (79) have proposed a set ...

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Section: (D) Other Combinationsmentioning

confidence: 99%

Combination Antifungal Therapy

Johnson

MacDougall

Ostrosky-Zeichner

et al. 2004

Antimicrob Agents Chemother

491

368

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“…11 This group was chosen as the control group because of the similar study design. All patients in the control group received L-AmB 3 mg/kg 3 times weekly during induction chemotherapy and during the subsequent neutropenic period.…”

Section: Historical Control Groupmentioning

confidence: 99%

“…1 In addition, it has been shown that ABLC and L-AmB are equally effective in the treatment of suspected or documented fungal infections in patients with acute leukemia, but only L-AmB has been evaluated as a prophylactic agent in patients with AML or MDS. 11,20 It has been shown that L-AmB is effective as antifungal prophylaxis during induction chemotherapy for patients with AML and high-risk MDS, with 49% of patients completing prophylaxis and only 4% of patients developing proven fungal infections during LAmB prophylaxis. 11 The prospective historical control study reported herein compared ABLC with L-AmB as antifungal prophylaxis in patients with AML and highrisk MDS who were undergoing induction chemotherapy.…”

mentioning

confidence: 99%

“…11,20 It has been shown that L-AmB is effective as antifungal prophylaxis during induction chemotherapy for patients with AML and high-risk MDS, with 49% of patients completing prophylaxis and only 4% of patients developing proven fungal infections during LAmB prophylaxis. 11 The prospective historical control study reported herein compared ABLC with L-AmB as antifungal prophylaxis in patients with AML and highrisk MDS who were undergoing induction chemotherapy.…”

mentioning

confidence: 99%

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Amphotericin B lipid complex as prophylaxis of invasive fungal infections in patients with acute myelogenous leukemia and myelodysplastic syndrome undergoing induction chemotherapy

Mattiuzzi

Kantarjian

Lim

et al. 2004

Cancer

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Ab initio quantum chemical computations have been done to determine the energetics and reaction pathways of hydroformylation of higher alkenes using a rhodium complex homogeneous catalyst. Calculation of fragments of the potential energy surfaces of the HRh(CO)(PPh3)3‐catalyzed hydroformylation of 1‐decene, 1‐dodecene, and styrene were performed by the restricted Hartree‐Fock method at the second‐order MØller‐Plesset (MP2) level of perturbation theory and basis set of 6‐31++G(d,p). Geometrically optimized structures of the intermediates and transition states were identified. Three generalized rate models were developed on the basis of above reaction path analysis as well as experimental findings reported in the literature. The kinetic and equilibrium parameters of the models were estimated by nonlinear least square regression of available literature data. The model based on H2‐oxidative addition fitted the data best; it predicts the conversion of all the alkenes quite satisfactorily with an average deviation of 7.6% and a maximum deviation of 13%. © 2009 American Institute of Chemical Engineers AIChE J, 2009

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“…Proven IFIs developed in 4% of the amphotericin lipid complex group and in 5% of the azole combination's recipients during a median of 12 days of therapy. 47 These data do not support the routine use of AmB and its lipid formulation as antifungal prophylaxis in this group of patients.…”

Section: Amphotericin Bmentioning

confidence: 82%

Choices aplenty: antifungal prophylaxis in hematopoietic stem cell transplant recipients

Hamza

Ghannoum

Lazarus

2004

Bone Marrow Transplant

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Summary:The incidence of invasive fungal infection (IFIs) in hematopoietic stem cell transplantation (HSCT) recipients ranges from 10 to 25% with an overall case fatality rate of up to 70-90%. Candida and Aspergillus genera remain the two most common pathogens. Although fluconazole prophylaxis in this population has been moderately effective in reducing mortality due to invasive candidiasis, this agent does not have activity against invasive aspergillosis (IA) and other mould. Several new agents such as voriconazole and caspofungin have enhanced potency and broad-spectrum antifungal activity and show promising results against yeasts and filamentous fungi when given as therapy and as chemoprophylaxis. Further, new diagnostic tools to detect circulating fungal antigens in biological fluids and PCR-based methods to detect species or genus-specific DNA or RNA have been developed. Incorporating these techniques along with clinical criteria appear to improve the accuracy of preclinical diagnosis of IFIs. Such approaches may alter the current treatment strategy from prophylaxis to preemptive therapy, thereby potentially decreasing cost and toxicity in high-risk patients.

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Liposomal amphotericin B versus the combination of fluconazole and itraconazole as prophylaxis for invasive fungal infections during induction

Cited by 71 publications

References 37 publications

Combination Antifungal Therapy

Combination Antifungal Therapy

Amphotericin B lipid complex as prophylaxis of invasive fungal infections in patients with acute myelogenous leukemia and myelodysplastic syndrome undergoing induction chemotherapy

Choices aplenty: antifungal prophylaxis in hematopoietic stem cell transplant recipients

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