title: Efficiency and safety of inhaled amphotericin B lipid complex (Abelcet) in the prophylaxis of invasive fungal infections following lung transplantation.
abstract: BACKGROUND
  Invasive fungal infections (IFIs) in patients undergoing lung transplantation (LT) are associated with significant mortality. Previous studies have shown the efficacy of aerosolized amphotericin B deoxycholate and oral fluconazole for antifungal prophylaxis. Evolving data show a potential advantage of prophylaxis with lipid-based formulations of amphotericin B in the prevention of IFIs. We reviewed the incidence of IFIs among patients receiving aerosolized amphotericin B lipid complex (ABLC) in LT.
  
  
  METHODS
  We undertook a retrospective review of the results of our antifungal protocol in a cohort of 60 LT patients. We analyzed the efficiency, safety, and tolerability of 50 mg of aerosolized ABLC administered postoperatively for IFI prophylaxis once every 2 days for 2 weeks and then once per week for at least 13 weeks. In addition, these transplanted patients received fluconazole (200 mg/d) during the first 21 days posttransplant. The prophylaxis-related efficiency and safety were quantified for IFIs and adverse events (AEs) for 6 months after study drug initiation.
  
  
  RESULTS
  Prophylaxis was efficient in 59 (98.3%) patients. Only one patient developed a possible IFI, due to Aspergillus fumigatus. Four patients presented nausea and vomiting as an AE, although aerosolized amphotericin B was ongoing.
  
  
  CONCLUSIONS
  Nebulized ABLC was effective, safe, and well tolerated for the prophylaxis of aspergillosis in lung transplant patients during the early posttransplant period.
authors.affiliation: Complejo Hospitalario Universitario Juan Canalejo, Servicio de Cirugía Torácica, La Coruña, Spain. jmborro@canalejo.org
authors.forename: J M
authors.initials: JM
authors.lastname: Borro
authors.forename: A
authors.initials: A
authors.lastname: Solé
authors.forename: M
authors.initials: M
authors.lastname: de la Torre
authors.forename: A
authors.initials: A
authors.lastname: Pastor
authors.forename: R
authors.initials: R
authors.lastname: Fernandez
authors.forename: A
authors.initials: A
authors.lastname: Saura
authors.forename: M
authors.initials: M
authors.lastname: Delgado
authors.forename: E
authors.initials: E
authors.lastname: Monte
authors.forename: D
authors.initials: D
authors.lastname: Gonzalez
mesh_terms: D000280:Administration, Inhalation; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000666:Amphotericin B / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001228:Aspergillosis / Q000517:prevention & control; D002648:Child; D005260:Female; D015725:Fluconazole / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000453:epidemiology / Q000517:prevention & control*; D009325:Nausea / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D012449:Safety; D014839:Vomiting / Q000209:etiology; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; C068538:liposomal amphotericin B; D000666:Amphotericin B; D015725:Fluconazole