Nebulized Amphotericin B Dosing Regimen for Aspergillus Prevention After Lung Transplant.
Exp Clin Transplant
; 19(1): 58-63, 2021 01.
Article
in En
| MEDLINE
| ID: mdl-33441058
ABSTRACT
OBJECTIVES:
Lung transplant guidelines recommend nebulized amphotericin B with or without systemic antifungal agents for fungal prophylaxis. However, amphotericin formulation, dosing, and frequency vary between studies. We assessed the safety and effectiveness of nebulized amphotericin B to prevent Aspergillus infection in 2 regimens, ie, twice daily compared with 3 times daily. MATERIALS ANDMETHODS:
This was a single-center retrospective cohort study. We included patients at least 14 years old who underwent lung transplant and received nebulized amphotericin B alone or in combination with another antifungal agent either twice daily or 3 times daily. The primary endpoint was the incidence of lung Aspergillus infection, and the secondary endpoints were nebulized amphotericin B side effects and breakthrough Aspergillus infection.RESULTS:
A total of 84 patients were included. The group given nebulized amphotericin twice daily had a higher rate of Aspergillus infection at 17% compared with 4% in the group treated 3 times daily (P = .24). No serious side effects were reported, but coughing and diarrhea were more common in patients who received amphotericin B 3 times daily.CONCLUSIONS:
A systemic antifungal agent combined with nebulized amphotericin either twice or 3 times daily has been effective to prevent Aspergillus infection. Nebulized amphotericin twice daily may be a more viable option to increase a patient's adherence and decrease medication cost and side effects. However, a larger randomized controlled trial is needed to determine the best dosing regimen for nebulized amphotericin B as a fungal prophylaxis after lung transplant.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Aspergillosis
/
Amphotericin B
/
Lung Transplantation
/
Antifungal Agents
Type of study:
Diagnostic_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Humans
Language:
En
Journal:
Exp Clin Transplant
Journal subject:
TRANSPLANTE
Year:
2021
Document type:
Article
Affiliation country:
Saudi Arabia