Use of high-dose liposomal amphotericin B: efficacy and tolerance.
Fungal infections have become increasingly prevalent over the past decade. Amphotericin B deoxycholate (AmBd) (Fungizone) has been the treatment of choice despite its association with significant high adverse effects, and notably severe high nephrotoxicity. However, liposomal ampotericin B (L-AmB) (AmBisome) has now become the first-line treatment due to its lower nephrotoxicity but without any loss of clinical efficacy. As illustrated in published reports, a higher dose of L-AmB may be prescribed in the case of unresponsiveness to treatment at normal dosage levels. Based on existing evidence from animal models of invasive fungal infections and the earlyclinical experience, L-AmB used athigher doses for invasive fungal infections is a new treatment option.
Garbino
Jorge
J
Division of Infectious Diseases, University Hospitals of Geneva, Geneva, Switzerland. jorge.garbino@hcuge.ch
Adam
Angeline
A
D000666:Amphotericin B / Q000008:administration & dosage*; D000935:Antifungal Agents / Q000008:administration & dosage*; D002648:Child; D003840:Deoxycholic Acid / Q000008:administration & dosage*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008081:Liposomes; D008875:Middle Aged; D020096:Zygomycosis / Q000188:drug therapy*
D000935:Antifungal Agents; D004338:Drug Combinations; D008081:Liposomes; C068538:liposomal amphotericin B; D003840:Deoxycholic Acid; D000666:Amphotericin B; C059765:amphotericin B, deoxycholate drug combination