title: Amphotericin B deoxycholate nasal spray administered to hematopoietic stem cell recipients with prior fungal colonization of the upper airway passages is associated with low rates of invasive fungal infection.
abstract: BACKGROUND
  Invasive fungal infections cause major problems during hematopoietic stem cell transplantation (HSCT). Fungal colonization of the upper airway passages occurs frequently, and may serve as a portal of entry for potentially life-threatening fungal infections, especially in immunocompromised patients.
  
  
  METHODS
  A clinical practice was instituted at Northwestern Memorial Hospital in Chicago in 2005, to administer amphotericin B deoxycholate nasal spray (ABNS) 0.5% to all HSCT recipients with fungal colonization of their nasal passages, in addition to standard oral antifungal prophylaxis.
  
  
  RESULTS
  Among 1945 HSCT patients treated during the study period, 109 patients were identified with positive fungal surveillance cultures.
  
  
  CONCLUSIONS
  Breakthrough fungal infections occurred in only 2 patients (2%), thus in this select group of HSCT recipients, ABNS administration is associated with a very low rate of breakthrough infection.
authors.affiliation: Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA; Northwestern Memorial Hospital, Chicago, Illinois, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: Trifilio
authors.forename: R
authors.initials: R
authors.lastname: Heraty
authors.forename: A
authors.initials: A
authors.lastname: Zomas
authors.forename: Z
authors.initials: Z
authors.lastname: Zhou
authors.forename: J L
authors.initials: JL
authors.lastname: Fong
authors.forename: D
authors.initials: D
authors.lastname: Liu
authors.forename: C
authors.initials: C
authors.lastname: Zhao
authors.forename: J
authors.initials: J
authors.lastname: Zhang
authors.forename: J
authors.initials: J
authors.lastname: Mehta
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000666:Amphotericin B / Q000008:administration & dosage*; D000935:Antifungal Agents / Q000008:administration & dosage*; D003840:Deoxycholic Acid / Q000008:administration & dosage*; D004338:Drug Combinations; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000517:prevention & control*; D059085:Nasal Sprays; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D004338:Drug Combinations; D059085:Nasal Sprays; D003840:Deoxycholic Acid; D000666:Amphotericin B; C059765:amphotericin B, deoxycholate drug combination
keywords: amphotericin B; antifungal nasal spray; colonization; fungal infection