Epidemiologia e terapia delle infezioni micotiche nell'ospite immunocompromesso, con particolare riguardo al ruolo delle formulazioni lipidiche di amfortericina B

Translated title of the contribution: Epidemiology and therapy of mycotic infections in immunocompromised patients, with particular attention to the role of lipid formulations of amphotericin B

Claudio Viscoli, Elio Castagnola

Research output: Contribution to journalArticle

Abstract

The extensive use of antifungal prophylaxis may have played a role in the increased incidence of invasive fungal infections in immunocompromised patients. Amphotericin B remains the antifungal agent with the broadest spectrum of action available and is thus the standard treatment for immunocompromised patients with proven or suspected fungal infections, especially aspergillosis. However, its potential for nephrotoxicity limits its usefulness. Lipid formulations of amphotericin B may allow therapy to be administered with reduced renal toxicity. Three different lipid formulations of amphotericin B are currently available. These compounds have different pharmacokinetics properties and usually achieve higher serum and/or tissue concentrations than amphotericin B. At present, there are no studies comparing the lipid formulations with each other and only a few randomized trials comparing them with conventional amphotericin B. However, a number of open clinical trials and compassionate-use protocols suggest that lipid-based forms of amphotericin B can achieve good response rates with minimal toxicity in patients with a variety of invasive mycoses, including those who have proved refractory or intolerant to previous therapy with conventional amphotericin B. Unfortunately, the cost of these compounds remains very high and may represent a limiting factor to their use.

Translated title of the contributionEpidemiology and therapy of mycotic infections in immunocompromised patients, with particular attention to the role of lipid formulations of amphotericin B
Original languageItalian
Pages (from-to)545-557
Number of pages13
JournalRecenti Progressi in Medicina
Volume90
Issue number10
Publication statusPublished - Oct 1999

ASJC Scopus subject areas

  • Medicine(all)

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