Efficacy of amphotericin B lipid complex in the treatment of invasive fungal infections in immunosuppressed paediatric patients.
The safety and efficacy of amphotericin B lipid complex (ABLC) were evaluated in a retrospective study of 46 paediatric patients with invasive infections. The study included a large proportion of patients who were refractory to or intolerant of conventional antifungal therapy. The mean age of the children was 9.7 +/- 4.8 years. Primary underlying conditions included mainly haematopoietic stem cell transplantation, leukaemia and lung transplantation. The mean daily dose given was 4.11 mg/kg for a mean duration of 38.7 days. At the end of therapy, 38 of 46 (83%) patients responded successfully to treatment with ABLC, including 18 of 23 (78%) with aspergillosis and 17 of 19 (89%) with candidiasis. ABLC was well tolerated, with a low incidence of adverse events. The mean creatinine value was 74.5 microl/mol/l at baseline and 78.2 micromol/l at the end of therapy. These results support the use of ABLC in the treatment of invasive fungal infections in children, including patients who have previously failed, or are intolerant of, traditional antifungal regimens.
Herbrecht
R
R
Département d'Hématologie et d'Oncologie, H pital de Hautepierre, Strasbourg, France. raoul.herbrecht@chru-strasbourg.fr
Auvrignon
A
A
Andrès
E
E
Guillemain
R
R
Suc
A
A
Eyer
D
D
Pailler
C
C
Letscher-Bru
V
V
Leverger
G
G
Schaison
G
G
D000293:Adolescent; D000666:Amphotericin B / Q000009:adverse effects / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001228:Aspergillosis / Q000188:drug therapy; D002177:Candidiasis / Q000188:drug therapy; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000652:urine; D004338:Drug Combinations; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016867:Immunocompromised Host; D007223:Infant; D007938:Leukemia / Q000276:immunology; D016040:Lung Transplantation / Q000276:immunology; D008297:Male; D009181:Mycoses / Q000188:drug therapy* / Q000276:immunology; D010713:Phosphatidylcholines / Q000009:adverse effects / Q000627:therapeutic use*; D010715:Phosphatidylglycerols / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies
D000935:Antifungal Agents; D004338:Drug Combinations; D010713:Phosphatidylcholines; D010715:Phosphatidylglycerols; C068538:liposomal amphotericin B; D000666:Amphotericin B; D003404:Creatinine