Ten years' experience with liposomal amphotericin B in transplant recipients at Huddinge University Hospital.
Our substantial experience in several trials with AmBisome in adult and paediatric patients undergoing transplantation has shown this formulation of amphotericin B to be safe and effective in therapeutic and prophylactic use. AmBisome has shown a significant reduction in fungal colonization and invasive Candida infections compared with placebo in a prospective, double-blind study in bone marrow transplantation, and eradication of invasive fungal infections in 86% of 14 children undergoing bone marrow transplantation. The main side effects of AmBisome use are elevations in serum potassium and creatinine, but these lead to very few withdrawals from treatment. Compared with conventional amphotericin B, AmBisome is very expensive, but its much improved safety profile and proven efficacy make it an excellent agent for management of invasive fungal disease in transplant recipients.
Ringdén
Olle
O
Department of Clinical Immunology, Centre for Allogeneic Stem Cell Transplantation, Karolinska Institute, Huddinge University Hospital, Huddinge S-14186, Sweden. olle.ringden@impi.ki.se
D000666:Amphotericin B / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000379:methods / Q000706:statistics & numerical data / Q000639:trends*; D000935:Antifungal Agents / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D006785:Hospitals, University / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D008081:Liposomes; D009181:Mycoses / Q000188:drug therapy / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology; D014180:Transplantation / Q000191:economics / Q000706:statistics & numerical data / Q000639:trends*
D000935:Antifungal Agents; D008081:Liposomes; D000666:Amphotericin B