Comparative efficacy of amphotericin B lipid complex and liposomal amphotericin B for the treatment of invasive fungal infections in HSCT recipients and other immunocompromised patient populations with hematologic malignancies: A critical review

Jayesh Mehta*, Julie Blake, Charles Craddock

*Corresponding author for this work

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Amphotericin B is an important agent for the treatment of invasive fungal infections in immunocompromised patients because of its broad spectrum. However, its toxicities and the availability of alternative agents limit its application. Lipid-based formulations of amphotericin B, such as amphotericin B lipid complex (ABLC) and liposomal amphotericin B (L-AMB), are less nephrotoxic and as effective as conventional amphotericin B. However, because of their similarities, choosing between the two formulations remains a challenge. The majority of prospective and retrospective comparative studies have shown equivalence in terms of efficacy although some subset analyses favor ABLC over L-AMB. While both drugs penetrate well in the reticuloendothelial system, ABLC gets concentrated in the lungs to a much greater extent. This may have clinical implications because the lungs are the commonest site of invasive fungal infections. L-AMB is associated with less infusion-related adverse effects and less nephrotoxicity than ABLC. ABLC has been shown to be more cost-effective than L-AMB, although this is affected by variable institutional contracts and pricing. The choice between the two drugs should be based upon due consideration of all these factors.

Original languageEnglish (US)
Pages (from-to)23-29
Number of pages7
JournalOpen Transplantation Journal
Volume5
DOIs
StatePublished - 2011

Keywords

  • Amphotericin B lipid complex
  • Fungal infections
  • Immunocompromised patients

ASJC Scopus subject areas

  • Transplantation

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