Successful use of amphotericin B lipid complex in the treatment of cryptococcosis.
The efficacy and renal safety of amphotericin B lipid complex (ABLC) injection were assessed in 106 patients with cryptococcal infection. Eighty-three patients (78%) had a central nervous system (CNS) infection. Of these patients, 20 initiated azole therapy concomitantly with ABLC therapy, and 7 had received prior azole therapy, which continued during administration of ABLC. Clinical response (cured or improved) was achieved in 67 (66%) of 101 patients whose results could be evaluated. Response rates were 65% (51/78) for patients with a CNS infection and 70% (16/23) for patients without a CNS infection. The response rate for patients with HIV infection was 58% (30/52). Response rates were 56% (19/34) for patients who were refractory to prior antifungal therapy, 65% (11/17) for patients who were intolerant of prior antifungal therapy, 60% (3/5) for patients with underlying renal disease who received prior antifungal therapy, 76% (25/33) for patients with underlying renal disease who did not receive prior antifungal therapy, and 73% (8/11) for patients with no renal disease who did not receive prior antifungal therapy. A mean serum creatinine level decrease of 0.02 mg/dL occurred. ABLC was an effective treatment for cryptococcal infection in immunocompromised patients.
Baddour
Larry M
LM
Division of Infectious Disease, Mayo Clinic, Rochester, Minnesota 55905, USA. baddour.larry@mayo.edu
Perfect
John R
JR
Ostrosky-Zeichner
Luis
L
D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000627:therapeutic use*; D003453:Cryptococcosis / Q000188:drug therapy*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D009894:Opportunistic Infections / Q000188:drug therapy*; D010713:Phosphatidylcholines / Q000627:therapeutic use*; D010715:Phosphatidylglycerols / Q000627:therapeutic use*; D012042:Registries; D016896:Treatment Outcome
D000935:Antifungal Agents; D004338:Drug Combinations; D010713:Phosphatidylcholines; D010715:Phosphatidylglycerols; C068538:liposomal amphotericin B; D000666:Amphotericin B