Treatment of central venous catheter fungal infection using liposomal amphotericin-B lock therapy.
The current standard of care for a fungal central venous catheter infection in a pediatric patient usually requires removal without any other feasible options. Although removal may reduce the rate of Candida-associated complications, literature reviews question whether the outcomes of removal substantiate this being the standard of care. We report 6 cases of central venous catheter fungal infections treated with liposomal amphotericin-B lock therapy. These cases consisted of 4 patients, 2 of whom received recurrent therapy. In 4 of these cases, there was successful eradication of the infectious fungal agent, allowing continued use of the catheter. A controlled study of antifungal lock therapy should be considered as a potential alternative to removal.
Buckler
Bradley S
BS
Department of Pediatrics, Medical College of Georgia, Augusta, GA 30912, USA. bbuckler@mcg.edu
Sams
Ralph N
RN
Goei
Vita L
VL
Krishnan
Karthik R
KR
Bemis
Marci J
MJ
Parker
Deidrea P
DP
Murray
Dennis L
DL
D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001769:Blood / Q000382:microbiology; D002176:Candida albicans / Q000187:drug effects / Q000302:isolation & purification; D041221:Candida glabrata / Q000187:drug effects / Q000302:isolation & purification; D002177:Candidiasis / Q000188:drug therapy* / Q000382:microbiology; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002648:Child; D003470:Culture Media; D005260:Female; D016469:Fungemia / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D007223:Infant; D008081:Liposomes / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D016896:Treatment Outcome
D000935:Antifungal Agents; D003470:Culture Media; D008081:Liposomes; C068538:liposomal amphotericin B; D000666:Amphotericin B