Antifungals and renal safety--getting the balance right.
Many patients who receive antifungal agents are immunocompromised or critically ill. This leaves many of these patients prone to renal failure, especially following transplantation. A wealth of clinical data have shown that older antifungal agents, particularly conventional amphotericin B deoxycholate (AmBd), are still highly efficacious, except that AmBd confers extensive nephrotoxicity. This paper examines the pharmacological alternatives that could provide a more suitable balance between clinical efficacy and renal safety.
Saliba
Faouzi
F
Department of Liver Disease and Liver Transplantation, Assistance Publique-Hôpitaux de Paris, Hôpital Paul Brousse, Villejuif, France. faouzi.saliba@pbr.aphp.fr
D000666:Amphotericin B / Q000008:administration & dosage* / Q000627:therapeutic use / Q000633:toxicity; D000935:Antifungal Agents / Q000009:adverse effects* / Q000627:therapeutic use / Q000633:toxicity*; D004338:Drug Combinations; D006801:Humans; D007668:Kidney / Q000187:drug effects*; D008081:Liposomes; D009181:Mycoses / Q000188:drug therapy*; D010713:Phosphatidylcholines / Q000627:therapeutic use / Q000633:toxicity; D010715:Phosphatidylglycerols / Q000627:therapeutic use / Q000633:toxicity
D000935:Antifungal Agents; D004338:Drug Combinations; D008081:Liposomes; D010713:Phosphatidylcholines; D010715:Phosphatidylglycerols; C068538:liposomal amphotericin B; D000666:Amphotericin B