title: Treatment of central venous catheter fungal infection using liposomal amphotericin-B lock therapy.
abstract: 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.
authors.affiliation: Department of Pediatrics, Medical College of Georgia, Augusta, GA 30912, USA. bbuckler@mcg.edu
authors.forename: Bradley S
authors.initials: BS
authors.lastname: Buckler
authors.forename: Ralph N
authors.initials: RN
authors.lastname: Sams
authors.forename: Vita L
authors.initials: VL
authors.lastname: Goei
authors.forename: Karthik R
authors.initials: KR
authors.lastname: Krishnan
authors.forename: Marci J
authors.initials: MJ
authors.lastname: Bemis
authors.forename: Deidrea P
authors.initials: DP
authors.lastname: Parker
authors.forename: Dennis L
authors.initials: DL
authors.lastname: Murray
mesh_terms: 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
chemical_list: D000935:Antifungal Agents; D003470:Culture Media; D008081:Liposomes; C068538:liposomal amphotericin B; D000666:Amphotericin B