title: Comparison between concentrations of amphotericin B in infected lung lesion and in uninfected lung tissue in a patient treated with liposomal amphotericin B (AmBisome).
abstract: Generally, the primary lesion of a mold infection is in the airway, an extravascular site. Therefore, the antifungal drug concentration at the actual tissue lesion of a mold infection is as important as in the blood compartment. Although our antifungal armamentarium has expanded recently, polyenes are still often needed in clinical practice because of their potent fungicidal activity and the rarity of resistance. Nevertheless, the distribution of amphotericin B (AmB) in infected lung tissue has not yet been evaluated. Using high-performance liquid chromatography analysis, we determined the concentrations of AmB in plasma and infected and uninfected tissues of resected lung simultaneously, in a patient with pulmonary aspergillosis treated with liposomal amphotericin B (L-AmB). The AmB concentration in the infected lesion of the lung was approximately 5.2 times higher than that in plasma and 3.7 times higher than in uninfected lung tissue. L-AmB accumulated in the infected lesion of the lung at a higher concentration. Although our data are from only one patient, they may be useful in helping to develop better strategies for the use of L-AmB against pulmonary fungal infections.
authors: Division of Control and Treatment of Infectious Diseases, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba, Japan.
authors: Akira
authors: A
authors: Watanabe
authors: Kana
authors: K
authors: Matsumoto
authors: Hidetoshi
authors: H
authors: Igari
authors: Masaya
authors: M
authors: Uesato
authors: Shigetoshi
authors: S
authors: Yoshida
authors: Yasutaka
authors: Y
authors: Nakamura
authors: Kunihiko
authors: K
authors: Morita
authors: Kazutoshi
authors: K
authors: Shibuya
authors: Hisahiro
authors: H
authors: Matsubara
authors: Ichiro
authors: I
authors: Yoshino
authors: Katsuhiko
authors: K
authors: Kamei
mesh_terms: D000666:Amphotericin B / Q000097:blood / Q000493:pharmacokinetics* / Q000627:therapeutic use; D000935:Antifungal Agents / Q000097:blood / Q000493:pharmacokinetics* / Q000627:therapeutic use; D001234:Aspergillus niger; D006801:Humans; D008081:Liposomes; D008168:Lung / Q000378:metabolism / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D055732:Pulmonary Aspergillosis / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism*; D014018:Tissue Distribution
chemical_list: D000935:Antifungal Agents; D008081:Liposomes; C068538:liposomal amphotericin B; D000666:Amphotericin B