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Safety and efficacy of liposomal amphotericin B for the empirical therapy of invasive fungal infections in immunocompromised patients

By Marisa H Miceli and Pranatharthi Chandrasekar


Liposomal amphotericin B is a “true” liposomal formulation of amphotericin B with greatly reduced nephrotoxicity and minimal infusion-related toxicity. This broad spectrum polyene is well tolerated and effective against most invasive fungal infections. In view of the current limitations on diagnostic capability of invasive fungal infections, most clinicians are often compelled to use antifungal drugs in an empiric manner; liposomal amphotericin B continues to play an important role in the empiric management of invasive fungal infections, despite the recent availability of several other drugs in the azole and echinocandin classes

Topics: Review
Publisher: Dove Medical Press
OAI identifier:
Provided by: PubMed Central

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  1. (2000). A randomized, double-blind comparative trial evaluating the safety of liposomal amphotericin B versus amphotericin B lipid complex in the empirical treatment of febrile neutropenia. L Amph/ABLC Collaborative Study Group. Clin Infect Dis.
  2. A randomized, double-blind, multicenter study of caspofungin versus liposomal amphotericin B for empiric antifungal therapy in pediatric patients with persistent fever and neutropenia. Pediatr Infect Dis
  3. (1995). Activities of amphotericin B and antifungal azoles alone and in combination against Pseudallescheria boydii. Antimicrob Agents Chemother.
  4. (1990). Amphotericin B: 30 years of clinical experience. Rev Infect Dis.
  5. (2003). Amphotericin B: time for a new “gold standard”. Clin Infect Dis.
  6. An open study of the comparative efficacy and safety of caspofungin and liposomal amphotericin B in treating invasive fungal infections or febrile neutropenia in patients with haematological malignancy.
  7. (1999). Antifungal agents: mode of action, mechanisms of resistance, and correlation of these mechanisms with bacterial resistance. Clin Microbiol Rev.
  8. (2004). Aspergillus fumigatus variant with decreased susceptibility to multiple antifungals. Antimicrob Agents Chemother.
  9. (2005). Aspergillus lentulus sp. nov, a new sibling species of A. fumigatus. Eukaryot Cell.
  10. Aspergillus ustus infections among transplant recipients. Emerg Infect Dis.
  11. (2004). Breakthrough fungal infections in stem cell transplant recipients receiving voriconazole. Clin Infect Dis.
  12. Breakthrough zygomycosis after voriconazole treatment in recipients of hematopoietic stem-cell transplants.
  13. Breakthrough zygomycosis during voriconazole treatment for invasive aspergillosis.
  14. (2003). Candida lusitaniae infections in the era of fluconazole availability. Clin Infect Dis.
  15. Candida nivariensis, an emerging pathogenic fungus with multidrug resistance to antifungal agents.
  16. Caspofungin versus liposomal amphotericin B for empirical antifungal therapy in patients with persistent fever and neutropenia.
  17. (2011). Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the infectious diseases society of america. Clin Infect Dis.
  18. Comparative in-vitro activity of voriconazole (UK-109,496) and six other antifungal agents against clinical isolates of Scedosporium prolificans and Scedosporium apiospermum.
  19. Comparison of the in vitro antifungal activity of free and liposome-encapsulated amphotericin B.
  20. Current options in antifungal pharmacotherapy.
  21. (2002). Defining opportunistic invasive fungal infections in immunocompromised patients with cancer and hematopoietic stem cell transplants: an international consensus. Clin Infect Dis.
  22. (2011). Diagnosis of invasive fungal infections in hematology and oncology – guidelines from the Infectious Diseases Working Party
  23. Disseminated aspergillosis caused by Aspergillus ustus in a patient following allogeneic peripheral stem cell transplantation.
  24. (1998). double-blind clinical trial of amphotericin B colloidal dispersion vs amphotericin B in the empirical treatment of fever and neutropenia. Clin Infect Dis.
  25. (2010). Drug-induced nephrotoxicity caused by amphotericin B lipid complex and liposomal amphotericin B: a review and meta-analysis. Medicine
  26. Echinocandin antifungal drugs in fungal infections: a comparison.
  27. Echinocandin antifungal drugs.
  28. Echinocandins: the newest class of antifungals.
  29. Emerging fungal diseases: the importance of the host.
  30. Emerging fungal resistance.
  31. Emerging moulds: epidemiological trends and antifungal resistance.
  32. Emerging opportunistic yeast infections. Lancet Infect Dis.
  33. Epidemiology of Aspergillus terreus at a university hospital.
  34. (2010). Evaluation of caspofungin or micafungin as empiric antifungal therapy in adult patients with persistent febrile neutropenia: a retrospective, observational, sequential cohort analysis. Clin Ther.
  35. (2006). FDA approvals. Avelox, Avandaryl, Trileptal. Available at: Accessed February 11,
  36. (2006). In vitro activities of posaconazole, fluconazole, itraconazole, voriconazole, and amphotericin B against a large collection of clinically important molds and yeasts. Antimicrob Agents Chemother.
  37. In vitro amphotericin B resistance in clinical isolates of Aspergillus terreus, with a head-to-head comparison to voriconazole.
  38. In-vitro antifungal susceptibility of clinical and environmental Fusarium spp strains.
  39. Invasive aspergillosis caused by Aspergillus ustus: case report and review.
  40. (2009). Invasive mold infections: recent advances in management approaches. Leuk Lymphoma.
  41. (1998). Invasive pulmonary aspergillosis due to Aspergillus terreus: 12-year experience and review of the literature. Clin Infect Dis.
  42. Liposomal amphotericin B for empirical therapy in patients with persistent fever and neutropenia.
  43. Liposomal amphotericin B: a review of its use as empirical therapy in febrile neutropenia and in the treatment of invasive fungal infections.
  44. (2008). Molecular identification and susceptibility testing of Trichosporon isolates from a Brazilian hospital. Rev Iberoam Micol.
  45. Non-albicans Candida spp causing fungaemia: pathogenicity and antifungal resistance.
  46. Outbreak of Candida rugosa candidemia: an emerging pathogen that may be refractory to amphotericin B therapy. Diagn Microbiol Infect Dis.
  47. Overview of the lipid formulations of amphotericin B.
  48. (2006). Posaconazole is effective as salvage therapy in zygomycosis: a retrospective summary of 91 cases. Clin Infect Dis.
  49. Rare and emerging opportunistic fungal pathogens: concern for resistance beyond Candida albicans and Aspergillus fumigatus.
  50. Results from the ARTEMIS DISK Global Antifungal Surveillance Study, 1997–2005. An 8.5-year analysis of susceptibilities of Candida species and other yeast species to fluconazole and voriconazole by CLSI standardized disk diffusion testing.
  51. Shifting patterns in the epidemiology of nosocomial Candida infections.
  52. Spectrum of clinically relevant Acremonium species in the United States.
  53. Voriconazole compared with liposomal amphotericin B for empirical antifungal therapy in patients with neutropenia and persistent fever.

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