Use of liposomal amphotericin B in critically ill patients: a retrospective, multicenter, clinical study.
The clinical use of liposomal amphotericin B in 179 patients admitted to 30 medical-surgical intensive Care Units (ICUs) treated with this agent in 2006 was analyzed. Invasive fungal infections were proven, probable and possible in 44%, 16%, and 25% of cases, respectively. Fungi isolated were Candida albicans (38%), non-albicans Candida spp. (15%) and Aspergillus spp. (7%). The mean duration of treatment was 15 days (mean dose 3.7 mg/kg/day). The drug was used as rescue treatment after fluconazole or caspofungin in 47% of patients and as first line in 52% with a satisfactory clinical response in 54% of cases (72.6% with proven infection). Microbiological eradication was achieved in 68% of cases. Adverse events occurred in 51 patients but were severe in only 4. The use of liposomal amphotericin B both as first line and rescue treatment and mainly for proven invasive fungal infection was associated with a high rate of satisfactory clinical response.
Alvarez-Lerma
F
F
Hospital Universitari del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain. Falvarez@imas.imim.es
Mariscal
F
F
Quintana
E
E
Rialp
G
G
Diaz-Reganon
J
J
Perez
M J
MJ
Alvarez-Sanchez
B
B
Ausin Aoiz
I
I
D018806:APACHE; D000328:Adult; D000368:Aged; D000666:Amphotericin B / Q000009:adverse effects / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000627:therapeutic use*; D016638:Critical Illness; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000188:drug therapy*; D012189:Retrospective Studies
D000935:Antifungal Agents; C068538:liposomal amphotericin B; D000666:Amphotericin B