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Treatment of systemic fungal infections with liposomal amphotericin B
G Lopez-Berestein1, G P Bodey, V Fainstein
1Division of Medicine, University of Texas M.D. Anderson Cancer Center, Houston 77030.
Abstract:
Forty-six patients with systemic fungal infections were treated with liposomal amphotericin B. Twenty-one patients had disseminated candidiasis, 19 had aspergillosis, and the rest had a variety of other fungal infections. Forty patients failed to respond to conventional amphotericin B therapy, and 6 patients were given liposomal amphotericin B because conventional amphotericin B caused severe side effects. Twenty-four patients had a complete response, and 22 patients failed to respond. No short- or long-term toxic reactions were observed. The acute side effects such as fever, chills, and potassium loss were infrequent and milder than those commonly observed with conventional amphotericin B. No chronic renal, hematologic, or central nervous system side effects were observed. Liposomal amphotericin B therapy was effective and less toxic than conventional amphotericin B therapy.
Insights
Liposomal amphotericin B effectively treated systemic fungal infections, showing fewer side effects than conventional amphotericin B. This new formulation offers a safer alternative for patients with candidiasis and aspergillosis.
Area of Science:
- Mycology
- Pharmacology
- Infectious Diseases
Background:
- Systemic fungal infections pose significant treatment challenges.
- Conventional amphotericin B is effective but associated with severe toxicities.
- Alternative formulations are needed to improve patient outcomes and tolerability.
Purpose of the Study:
- To evaluate the efficacy and safety of liposomal amphotericin B in patients with systemic fungal infections.
- To compare the adverse event profile of liposomal amphotericin B with conventional amphotericin B.
- To assess the response rates in patients refractory to or intolerant of conventional amphotericin B.
Main Methods:
- A cohort of 46 patients with systemic fungal infections received liposomal amphotericin B.
- Patients included those with disseminated candidiasis, aspergillosis, and other fungal infections.
- Treatment outcomes and adverse events were monitored.
Main Results:
- Twenty-four out of 46 patients achieved a complete response.
- Liposomal amphotericin B was used in 40 patients who failed conventional therapy and 6 who experienced severe side effects.
- Acute side effects were infrequent and milder compared to conventional amphotericin B; no chronic toxicities were observed.
Conclusions:
- Liposomal amphotericin B demonstrates significant efficacy in treating systemic fungal infections.
- The liposomal formulation offers a favorable safety profile with reduced toxicity compared to conventional amphotericin B.
- Liposomal amphotericin B represents a valuable therapeutic option for managing invasive fungal infections, particularly in patients with limited tolerance to conventional treatments.