scholarly journals 10 Comparing antifungal prophylaxis efficacy between fluconazole and amphotericin B lipid complex in adult patients with acute lymphocytic leukemia (ALL) receiving hyper-CVAD-based chemotherapy

2019 ◽  
Author(s):  
Afnan Yousef Alamri ◽  
Mansoor Ahmed Khan ◽  
Mohammed Aseeri ◽  
Ahmed Absi ◽  
Abdelmajid Alnatsheh
Keyword(s):  
Amphotericin B ◽  
Acute Lymphocytic Leukemia ◽  
Antifungal Prophylaxis ◽  
Lymphocytic Leukemia ◽  
Adult Patients ◽  
Lipid Complex ◽  
Amphotericin B Lipid Complex

scholarly journals Invasive Fungal Infection After Lung Transplantation: Epidemiology in the Setting of Antifungal Prophylaxis

2019 ◽  
Vol 70 (1) ◽  
pp. 30-39 ◽  
Author(s):  
Arthur W Baker ◽  
Eileen K Maziarz ◽  
Christopher J Arnold ◽  
Melissa D Johnson ◽  
Adrienne D Workman ◽  
...  
Keyword(s):  
Lung Transplantation ◽  
Amphotericin B ◽  
Prevalence Rate ◽  
Lung Transplant ◽  
Tertiary Care ◽  
Antifungal Prophylaxis ◽  
Transplant Recipients ◽  
Lipid Complex ◽  
Amphotericin B Lipid Complex ◽  
Lung Transplant Recipients

Abstract Background Lung transplant recipients commonly develop invasive fungal infections (IFIs), but the most effective strategies to prevent IFIs following lung transplantation are not known. Methods We prospectively collected clinical data on all patients who underwent lung transplantation at a tertiary care academic hospital from January 2007–October 2014. Standard antifungal prophylaxis consisted of aerosolized amphotericin B lipid complex during the transplant hospitalization. For the first 180 days after transplant, we analyzed prevalence rates and timing of IFIs, risk factors for IFIs, and data from IFIs that broke through prophylaxis. Results In total, 156 of 815 lung transplant recipients developed IFIs (prevalence rate, 19.1 IFIs per 100 surgeries, 95% confidence interval [CI] 16.4–21.8%). The prevalence rate of invasive candidiasis (IC) was 11.4% (95% CI 9.2–13.6%), and the rate of non-Candida IFIs was 8.8% (95% CI 6.9–10.8%). First episodes of IC occurred a median of 31 days (interquartile range [IQR] 16–56 days) after transplant, while non-Candida IFIs occurred later, at a median of 86 days (IQR 40–121 days) after transplant. Of 169 IFI episodes, 121 (72%) occurred in the absence of recent antifungal prophylaxis; however, IC and non-Candida breakthrough IFIs were observed, most often representing failures of micafungin (n = 16) and aerosolized amphotericin B (n = 24) prophylaxis, respectively. Conclusions Lung transplant recipients at our hospital had high rates of IFIs, despite receiving prophylaxis with aerosolized amphotericin B lipid complex during the transplant hospitalization. These data suggest benefit in providing systemic antifungal prophylaxis targeting Candida for up to 90 days after transplant and extending mold-active prophylaxis for up to 180 days after surgery.

Antifungal Prophilaxis with Low Dose Amphotericin B Lipid Complex In Patients with Acute Myeloid Leukaemia: A Single Centre Experience

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4303-4303
Author(s):  
Barbara Veggia ◽  
Francesca Saltarelli ◽  
Enrico Montefusco ◽  
Esmeralda Conte ◽  
Giusy Antolino ◽  
...  
Keyword(s):  
Amphotericin B ◽  
Low Dose ◽  
Fungal Infections ◽  
Antifungal Prophylaxis ◽  
Cell Transplant ◽  
Intensive Chemotherapy ◽  
Newly Diagnosed ◽  
Lipid Complex ◽  
Amphotericin B Lipid Complex ◽  
Acute Myeloid

Abstract Abstract 4303 INTRODUCTION Invasive fungal infections (IFI) represent an important cause of mortality and morbidity in patients with Acute Myeloid Leukemia (AML) undergoing intensive chemotherapy. A prophylactic antifungal therapy is often administered during intensive chemotherapy, however the optimal antifungal prophylaxis protocol is still unknown. Amphotericin B lipid complex (Abelcet®) has been commonly used as a standard treatment for IFIs caused by Aspergillus and Candida, but its effectiveness in prophilaxis has not been clearly estabilished. METHODS From September 2010 to April 2011 we treated six patients with newly diagnosed AML using low dose amphotericin B lipid complex as antifungal prophilaxis. Patients observed were three females and 3 males, median age was 54 years (range 21–74 years) and they were all fit to receive intensive chemotherapy. Three patients older than 60 years received Fludarabine based chemotherapy regimen during both induction and consolidation. Three patients aged less than 60 years old were treated using a chemotherapy protocol based on Citarabine, Daunorubicin and Ethoposide association. One patient in this group also underwent BuCy conditioned autologous stem cell transplant. Amphotericin B lipid complex was administered intravenously at 100 mg once a day. Antifungal prophilaxis was started when the absolute neutrophil count was ≤ 500 cells/μ l and was continued until neutrophils recovery was ≥ 500 cells/μ l, without any evidence of IFI. RESULTS Five patients did not experience any proven fungal infection during all treatment. Anyway one patient died during induction due to a severe bacterial lung infection. One patients discontinued antifungal prophylaxis due to extensive skin rash during the second infusion of the drug. Amphotericin B lipid complex was otherwise well tolerated by patients. One patient was diagnosed with lung aspergillosis infection by evidence of galattomannan positivity on BAL and a lung CT scan showing a single nodular escavated lesion on left upper lobe; subsequentely he was successfully treated with voriconazole. CONCLUSIONS In our experience, Amphotericin B lipid complex showed to be an effective and safe antifungal prophylaxis for newly diagnosed AML patients. Further clinical studies are certainly required to obtain definitive data. Disclosures: No relevant conflicts of interest to declare.

Two-year Longitudinal Evaluation of Amphotericin B Lipid Complex Injection in a Tertiary Care Medical Center

2000 ◽  
Vol 35 (2) ◽  
pp. 176-181 ◽  
Author(s):  
Leanne D. Kennedy ◽  
Julie F. Connelly ◽  
Kevin M. Kuzma
Keyword(s):  
Serum Creatinine ◽  
Amphotericin B ◽  
Fungal Infections ◽  
Tertiary Care ◽  
Serum Creatinine Concentration ◽  
Creatinine Concentration ◽  
Lipid Complex ◽  
Tertiary Care Medical Center ◽  
Amphotericin B Lipid Complex ◽  
The Mean

A 2-year concurrent drug use evaluation was conducted in 156 patients to determine whether Abelcet (amphotericin B lipid complex injection) was being prescribed according to institution-approved guidelines and to characterize the patient population receiving Abelcet. Eighty-nine patients (57%) had fungal infections documented by chest x-ray, computed tomography, or fungal cultures. Sixty-seven (43%) had clinically suspected fungal infections. The Abelcet mean dose by weight was 5 mg/kg/day (actual body weight). Seventy-one patients (46%) met the established guidelines for use; 85 (54%) did not. Premedication was given to 64% of the patients; only 15 patients (10%) experienced documented fever and chills. A total of 72 patients (46%) died during therapy. Of the 75 patients who completed therapy in the hospital, 41 were switched to conventional amphotericin B, fluconazole, or itraconazole following a decrease in serum creatinine concentration, and 34 did not receive further antifungal therapy. The mean length of Abelcet therapy was 11 days. The mean increase in serum creatinine concentration at discontinuation of therapy was 0.2 mg/dL. Continued monitoring of Abelcet use was recommended and established guidelines were reaffirmed. Hydration with normal saline before and after dosing was suggested to help improve renal function, and dopamine was recommended to increase renal blood flow.

Amphotericin B Lipid Complex

Drugs ◽  
2004 ◽  
Vol 64 (17) ◽  
pp. 1905-1911 ◽  
Author(s):  
David R Goldsmith ◽  
Caroline M Perry
Keyword(s):  
Amphotericin B ◽  
Lipid Complex ◽  
Amphotericin B Lipid Complex

scholarly journals Combination Echinocandin-Polyene Treatment of Murine Mucormycosis

2008 ◽  
Vol 52 (4) ◽  
pp. 1556-1558 ◽  
Author(s):  
Ashraf S. Ibrahim ◽  
Teclegiorgis Gebremariam ◽  
Yue Fu ◽  
John E. Edwards ◽  
Brad Spellberg
Keyword(s):  
Amphotericin B ◽  
Liposomal Amphotericin ◽  
Class Effect ◽  
Lipid Complex ◽  
Enhanced Activity ◽  
Amphotericin B Lipid Complex ◽  
Disseminated Mucormycosis

ABSTRACT We previously found that caspofungin synergized with amphotericin B lipid complex in treating murine mucormycosis. We now report a similarly enhanced activity of liposomal amphotericin combined with micafungin or anidulafungin in mice with disseminated mucormycosis. The efficacy of combination echinocandin-polyene therapy for mucormycosis is a class effect.

scholarly journals Pharmacokinetic profile of ABELCET (amphotericin B lipid complex injection): combined experience from phase I and phase II studies.

1997 ◽  
Vol 41 (10) ◽  
pp. 2201-2208 ◽  
Author(s):  
A Adedoyin ◽  
J F Bernardo ◽  
C E Swenson ◽  
L E Bolsack ◽  
G Horwith ◽  
...  
Keyword(s):  
Amphotericin B ◽  
Interindividual Variability ◽  
Pharmacokinetic Profile ◽  
Volume Of Distribution ◽  
Lipid Complex ◽  
Phase Ii Studies ◽  
Amphotericin B Lipid Complex ◽  
Trough Concentrations ◽  
Dose Limiting Toxicity ◽  
Wide Interindividual Variability

Amphotericin B (AmB) has been the most effective systemic antifungal agent, but its use is limited by the dose-limiting toxicity of the conventional micellar dispersion formulation (Fungizone). New formulations with better and improved safety profiles are being developed and include ABELCET (formerly ABLC), but their dispositions have not been well characterized; hence, the reason for their improved profiles remains unclear. This report details the pharmacokinetics of ABELCET examined in various pharmacokinetic and efficacy studies by using whole-blood measurements of AmB concentration performed by high-pressure liquid chromatography. The data indicated that the disposition of AmB after administration of ABELCET is different from that after administration of Fungizone, with a faster clearance and a larger volume of distribution. It exhibits complex and nonlinear pharmacokinetics with wide interindividual variability, extensive distribution, and low clearance. The pharmacokinetics were unusual. Clearance and volume of distribution were increased with dose, peak and trough concentrations after multiple dosings increased less than proportionately with dose, steady state appeared to have been attained in 2 to 3 days, despite an estimated half-life of up to 5 days, and there was no evidence of significant accumulation in the blood. The data are internally consistent, even though they were gathered under different conditions and circumstances. The pharmacokinetics of ABELCET suggest that lower concentrations in blood due to higher clearance and greater distribution may be responsible for its improved toxicity profile compared to those of conventional formulations.

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