Related Experiment Videos

Use of liposomal amphotericin B in critically ill patients: a retrospective, multicenter, clinical study

F Alvarez-Lerma1, F Mariscal, E Quintana

  • 1Hospital Universitari del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain. Falvarez@imas.imim.es

Journal of Chemotherapy (Florence, Italy)
|July 2, 2009
PubMed

Insights

Liposomal amphotericin B effectively treats invasive fungal infections in intensive care units (ICUs). This antifungal agent showed a high clinical response rate, even when used as rescue therapy.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Pharmacology

Background:

  • Invasive fungal infections (IFIs) pose a significant threat in medical-surgical intensive care units (ICUs).
  • Liposomal amphotericin B is a key antifungal agent used in managing severe infections.
  • Understanding its clinical utility in diverse ICU settings is crucial for treatment optimization.

Purpose of the Study:

  • To analyze the clinical use and effectiveness of liposomal amphotericin B in a cohort of ICU patients.
  • To evaluate treatment outcomes, including clinical response and microbiological eradication.
  • To assess the safety profile of liposomal amphotericin B in this patient population.

Main Methods:

  • Retrospective analysis of 179 patients treated with liposomal amphotericin B in 30 ICUs during 2006.
  • Categorization of fungal infections as proven, probable, or possible.
  • Documentation of treatment duration, dosage, clinical response, microbiological eradication, and adverse events.

Main Results:

  • Invasive fungal infections were documented in 44% (proven), 16% (probable), and 25% (possible) of patients.
  • Candida species (albicans and non-albicans) and Aspergillus species were the most common fungi identified.
  • A satisfactory clinical response was observed in 54% of patients overall (72.6% with proven infection), with 68% achieving microbiological eradication.
  • Adverse events occurred in 51 patients, but only 4 experienced severe events.

Conclusions:

  • Liposomal amphotericin B demonstrates a high rate of satisfactory clinical response when used as both first-line and rescue therapy for invasive fungal infections in ICUs.
  • Its efficacy is particularly notable in patients with proven infections.
  • The agent is generally well-tolerated, with a low incidence of severe adverse events.

Related Concept Videos

Antifungal Agents01:15

Antifungal Agents

Amphotericin B is a broad-spectrum antifungal agent that exploits structural differences between fungal and mammalian cell membranes. Its amphipathic structure—featuring a hydrophobic polyene-lactone ring and a hydrophilic region containing mycosamine and carboxylic acid groups—enables selective binding to ergosterol, a sterol predominantly found in fungal plasma membranes. This selective interaction underlies the drug’s antifungal activity, although weak binding to cholesterol contributes to...
Cryptococcal Meningitis01:27

Cryptococcal Meningitis

Cryptococcal meningitis is a life-threatening opportunistic infection predominantly associated with HIV/AIDS, accounting for over 100,000 deaths annually worldwide. However, it also affects individuals with other forms of immunosuppression, including those undergoing immunosuppressive therapy, organ transplant recipients, patients with innate immunodeficiencies, and individuals with hematological disorders. The infection is caused mainly by Cryptococcus neoformans and Cryptococcus gattii,...