A pilot study of prophylactic aerosolized amphotericin b in patients at risk for prolonged neutropenia

Susan E. Myers*, Steven M. Devine, Romy L. Topper, Margaret Ondrey, Carol Chandler, Kathleen Otoole, Stephanie F. Williams, Richard A. Larson, Robert B. Geller

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

43 Scopus citations

Abstract

Invasive aspergillosis continues to be a significant cause of morbidity and mortality in patients with prolonged neutropenia. We performed a phase I trial of escalating doses of aerosolized amphotericin B given by a face mask nebulizer system with a disposable bacterial exhale filter. Five, 10, 15, and 20 mg of drug were disolved in sterile water and inhaled over 10 to 15 minutes twice daily. Tolerance was studied in 26 patients (18 transplant recipients, and 8 leukemia patients). No side effects were observed at any dose level. Prophylactic treatment ended for 14 patients (54% when intravenous (IV) amphotericin B was begun empirically for antifungal coverage following fevers. Eleven patients (43% continued inhaled amphotericin B until blood counts recovered. One patient was taken off study when she developed cardiogenic pulmonary edema. No patient developed clinically suspicious or pathologically documented infection with invasive aspergillosis. Prophylactic aerosolized amphotericin B is well tolerated at 5, 10, 15, and 20 mg twice daily dosing. In addition, prophylactic aerosolized amphotericin B does not appear to sensitize patients to the subsequent use of IV amphotericin B. Although this study suggests that prophylactic inhaled amphotericin B is well tolerated and effective, a large scale controlled trial is needed.

Original languageEnglish (US)
Pages (from-to)229-233
Number of pages5
JournalLeukemia and Lymphoma
Volume8
Issue number3
DOIs
StatePublished - 1992
Externally publishedYes

Keywords

  • Aerosolized amphotericin B
  • Amphotericin B
  • Prolonged neutropenia

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Fingerprint

Dive into the research topics of 'A pilot study of prophylactic aerosolized amphotericin b in patients at risk for prolonged neutropenia'. Together they form a unique fingerprint.

Cite this