Nebulized Amphotericin B Combined with Intravenous Amphotericin B in Rats with Severe Invasive Pulmonary Aspergillosis

Ruijgrok, Elisabeth J.; Fens, Marcel H.A.M.; Bakker-Woudenberg, Irma A. J. M.; Etten, Els W. M. van; Vulto, Arnold G.

doi:10.1128/aac.50.5.1852-1854.2006

Cited by 12 publications

(17 citation statements)

References 12 publications

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“…We identified 11 potentially eligible studies of which 8 studies (16–23) fulfilled the inclusion criteria and were subject to meta‐analysis (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

“…Three of the pooled studies evaluated nebulized AmB as prophylaxis (17–19), 3 studies evaluated AmB as a therapeutic agent (21–23), and 2 studies evaluated the effect of nebulized AmB both as a preventive and therapeutic agent in different subgroups of animals within the same study (16, 20). Concurrent administration of intravenous liposomal AmB was used in both the control and nebulized AmB treatment group in 2 therapeutic trials (21, 23).…”

Section: Resultsmentioning

confidence: 99%

“…Systemic steroid was used to induce the immunosuppressed state in 5 studies (17–20, 23) and cyclophosphamide was used to induce immunosuppressed state in the other 3 studies (16, 21, 22). Two studies evaluated AmB‐d (19, 20), 1 study evaluated liposomal AmB (21), and the remaining 5 studies evaluated more than one formulation of AmB (16–18, 22, 23). All the pooled studies included a placebo group, but none of the studies described the method of randomization, allocation concealment, and blinding.…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Meta‐analysis of nebulized amphotericin B to prevent or treat pulmonary aspergillosis in immunosuppressed animals

Ho¹,

Duff²,

Chambers³

et al. 2008

Transplant Infectious Dis

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The use of nebulized amphotericin, either as a prophylactic or therapeutic agent, is effective in reducing mortality of immunosuppressed animals with pulmonary aspergillosis. A large randomized controlled trial is needed to confirm whether combining nebulized amphotericin with systemic antifungal agents will reduce mortality in immunosuppressed patients with suspected or proven pulmonary aspergillosis.

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“…We identified 11 potentially eligible studies of which 8 studies (16–23) fulfilled the inclusion criteria and were subject to meta‐analysis (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Meta‐analysis of nebulized amphotericin B to prevent or treat pulmonary aspergillosis in immunosuppressed animals

Ho¹,

Duff²,

Chambers³

et al. 2008

Transplant Infectious Dis

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show abstract

“…When nebulized, these products produce particle sizes with MMAD ranging from 0.90-2.43 µm, making aerosol administration feasible. 128 The use of Respirgard II and PariBoy or Pari IS II (both Pari Werke, Starnberg, Germany) for nebulization of amphotericin B deoxycholate has shown to generate particles that deposit in the alveoli, trachea, and nasopharynx. 129 Other studies have evaluated the intrapulmonary pharmacokinetics of nebulized amphotericin B with use of different nebulizers and formulations.…”

Section: Fungal Infectionsmentioning

confidence: 99%

Consensus Summary of Aerosolized Antimicrobial Agents: Application of Guideline Criteria

Lê

Ashley

Neuhauser³

et al. 2010

Pharmacotherapy

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Aerosolized delivery of antimicrobial agents is an attractive option for management of pulmonary infections, as this is an ideal method of providing high local drug concentrations while minimizing systemic exposure. With the paucity of consensus regarding the safety, efficacy, and means with which to use aerosolized antimicrobials, a task force was created by the Society of Infectious Diseases Pharmacists to critically review and evaluate the literature on the use of aerosolized antiinfective agents. This article summarizes key findings and statements for preventing or treating a variety of infectious diseases, including cystic fibrosis, bronchiecstasis, hospital-acquired pneumonia, fungal infections, nontuberculosis mycobacterial infection, and Pneumocystis jiroveci pneumonia. Our intention was to provide guidance for clinicians on the use of aerosolized antibiotics through evidence-based pharmacotherapy. Further research with well-designed clinical trials is necessary to elucidate the optimal dosage and duration of therapy and, of equal importance, to appreciate the true risks associated with the use of aerosolized delivery systems.

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“…However, the use of the amphotericin B inhalations for the treatment of pulmonary fungal infections has also been proposed and has demonstrated efficacy among several animal models [30][31][32][33][34] . Additionally, the use of aerosolized amphotericin B given in combination with intravenous amphotericin B may be a useful option in the treatment of pulmonary aspergillosis [31] . Intranasal amphotericin B for prophylaxis against Aspergillus infections has also been clinically evaluated, although conflicting outcomes have been demonstrated [35][36][37] .…”

Section: Clinical Effi Cacymentioning

confidence: 99%

Safety of aerosolized amphotericin B

Knechtel

Klepser

2007

Expert Opinion on Drug Safety

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Aerosolized delivery of a number of antimicrobial agents has been studied. Despite a theoretical soundness behind this strategy, full consideration of the potential toxicities associated with this mode of administration is imperative. Aerosolized amphotericin B, as both deoxycholate and lipid formulations, has been studied in a variety of high-risk patient populations for prophylaxis and treatment against fungal infections. Although available data remain inconclusive regarding the clinical efficacy of this therapy, variability among results may be due to lack of standardization of administration methods and doses. Akin to the lack of clinical consensus, data regarding the tolerability of this means of amphotericin B delivery are conflicting. This variability may again be accounted for by the lack of standardized means for aerosolized administration. Owing to uncertain clinical benefit and concern for pulmonary toxicities, the use of aerosolized amphotericin B should be limited to clinical investigations at this time.

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Nebulized Amphotericin B Combined with Intravenous Amphotericin B in Rats with Severe Invasive Pulmonary Aspergillosis

Cited by 12 publications

References 12 publications

Meta‐analysis of nebulized amphotericin B to prevent or treat pulmonary aspergillosis in immunosuppressed animals

Meta‐analysis of nebulized amphotericin B to prevent or treat pulmonary aspergillosis in immunosuppressed animals

Consensus Summary of Aerosolized Antimicrobial Agents: Application of Guideline Criteria

Safety of aerosolized amphotericin B

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