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Titolo:
Review of comparative studies between conventional and liposomal amphotericin B (Ambisome (R)) in neutropenic patients with fever of unknown origin and patients with systemic mycosis
Autore:
Blau, IW; Fauser, AA;
Indirizzi:
Clin Bone Marrow Transplantat & Haematol Oncol, Idar Oberstein, Germany Clin Bone Marrow Transplantat & Haematol Oncol Idar Oberstein Germany y
Titolo Testata:
MYCOSES
fascicolo: 9-10, volume: 43, anno: 2000,
pagine: 325 - 332
SICI:
0933-7407(2000)43:9-10<325:ROCSBC>2.0.ZU;2-X
Fonte:
ISI
Lingua:
ENG
Soggetto:
MARROW TRANSPLANT RECIPIENTS; INVASIVE FUNGAL-INFECTIONS; ANTIFUNGAL PROPHYLAXIS; RANDOMIZED TRIAL; ASPERGILLOSIS; THERAPY;
Keywords:
amphotericin B; liposomal amphotericin B; antimycotic chemotherapy; fever of unknown origin; immunocompromised patient;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
31
Recensione:
Indirizzi per estratti:
Indirizzo: Fauser, AA Klin Knochenmarktransplantat, Dr O Kohler Str 2, D-55743 Idar Oberstein, Germany Klin Knochenmarktransplantat Dr O Kohler Str 2 Idar Oberstein Germany D-55743
Citazione:
I.W. Blau e A.A. Fauser, "Review of comparative studies between conventional and liposomal amphotericin B (Ambisome (R)) in neutropenic patients with fever of unknown origin and patients with systemic mycosis", MYCOSES, 43(9-10), 2000, pp. 325-332

Abstract

Fungal infections are an important cause of morbidity and mortality in immunocompromised patients. Treatment with amphotericin B is the main therapeutic approach. However, this treatment is limited by the substantial toxicity. We present the data of the first randomized prospective comparative trial in adults (134 patients with fever of unknown origin) with conventional amphotericin B and a liposomal formulation of amphotericin B (AmBisome(R), published in 1997 by Prentice et al. (Br. J. Haematol. 98, 711-718) and the data of adults with documented fungal infections (59.patients), treated in this trial. Patients received either conventional amphotericin B 1mgkg(-1) per day, liposomal amphotericin B 1mgkg(-1) per day or liposomal amphotericin B 3 mg kg(-1) per day. Patients were entered if they had fever of unknown origin (FUO), defined as temperature of 38 degreesC or more, not responding to 96 h of systemic broad-spectrum antibiotic treatment, and neutropenia(< 0.5 x 10(9) 1(-1)). Efficacy of treatment was assessed, with success defined as resolution of fever for three consecutive days (< 38 degreesC) in the group of patients with FUO and the freedom of clinical signs and/or theelimination of fungus in the group of patients with documented fungal infections. The safety of treatment and renal and hepatic toxicity of liposomaland conventional amphotericin B were compared. No statistically significant difference was found in the treatment efficacy in the three study arms. However, there is a tendency of better treatment results in the two groups of patients, who received liposomal amphotericin B. Thirty-five per cent of patients with documented fungal infections and 46% of patients with FUO responded to amphotericin B. In the patients group, that received 1 mg kg(-1) liposomal amphotericin B it was 63 and 49%, in the group of patients that received 3 mg kg-l liposomal amphotericin B it was 47 and 64%. Evidence of toxicity due to amphotericin B was seen in 50 patients (83%), toxicity due to liposomal amphotericin B, 1 mg kg(-1), was seen in 35 patients (50%), anddue to liposomal amphotericin B 3 mg kg(-1) in 34 patients (54%). This wasa statistically significant difference (P=0.001). It was concluded that liposomal amphotericin B was safer than conventional amphotericin B, but bothformulations are equivalent in treatment efficacy. The prophylactic use ofamphotericin B in these immunocompromised patients is discussed.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 27/09/20 alle ore 01:01:32