Comparison of the safety and cost-effectiveness of nebulized liposomal amphotericin B and amphotericin B deoxycholate for antifungal prophylaxis after lung transplantation.
J Infect Chemother
; 30(8): 741-745, 2024 Aug.
Article
in En
| MEDLINE
| ID: mdl-38354908
ABSTRACT
INTRODUCTION:
Fungal infection after lung transplantation can lead to poor clinical outcome, for which lung transplant recipients require prophylaxis. One of the antifungal agents used after lung transplantation is nebulized amphotericin B (AMB). Nebulized AMB causes adverse events such as dyspnea and airway irritation, and long-term use leads to high economic costs. So far, prophylactic regimens employing AMB deoxycholate (AMB-d) and liposomal AMB (L-AMB) have been developed. This study compared the efficacy, safety, and cost of AMB-d and L-AMB. PATIENTS ANDMETHODS:
Patients who underwent lung transplantation at Kyoto University Hospital from January 2021 to May 2023 were included in this study. Thirty-three patients received nebulized AMB-d, whereas 29 received nebulized L-AMB.RESULTS:
Both regimens maintained comparable prophylactic efficacy regarding the development of fungal infection in the AMB-d and L-AMB groups (3.0% vs. 3.4%, P = 0.877). Patients treated with nebulized L-AMB experienced fewer respiratory-related adverse reactions than those treated with nebulized AMB-d (6.9% vs. 30.3%, P < 0.05), leading to a longer treatment duration with L-AMB than with AMB-d. Additionally, the daily cost of administering L-AMB was lower than that of administering AMB-d (3609 Japanese yen vs. 1792.3 Japanese yen, P < 0.05).DISCUSSION:
These results suggest that nebulized L-AMB is safer and more cost-effective than nebulized AMB-d, with comparable efficacy.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Nebulizers and Vaporizers
/
Amphotericin B
/
Lung Transplantation
/
Cost-Benefit Analysis
/
Deoxycholic Acid
/
Drug Combinations
/
Mycoses
/
Antifungal Agents
Type of study:
Health_economic_evaluation
Limits:
Adult
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Aged
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Female
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Humans
/
Male
/
Middle aged
Country/Region as subject:
Asia
Language:
En
Journal:
J Infect Chemother
Journal subject:
MICROBIOLOGIA
/
TERAPIA POR MEDICAMENTOS
Year:
2024
Document type:
Article
Affiliation country:
Country of publication: