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 Candid...

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Published in:Journal of chemotherapy (Florence) 2009-06, Vol.21 (3), p.330
Main Authors: Alvarez-Lerma, F, Mariscal, F, Quintana, E, Rialp, G, Diaz-Reganon, J, Perez, M J, Alvarez-Sanchez, B, Ausin Aoiz, I
Format: Article
Language:English
Subjects:
Adult
Aged
Amphotericin B - adverse effects
Amphotericin B - therapeutic use
Antifungal Agents - therapeutic use
APACHE
Critical Illness
Female
Humans
Intensive Care Units
Male
Middle Aged
Mycoses - drug therapy
Retrospective Studies
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Summary: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.
ISSN:1973-9478
DOI:10.1179/joc.2009.21.3.330