Leenders AC, Daenen S, Jansen R, Hop WC, Lowenberg B, Wijermans PW, Cornelissen J, Herbrecht R, van der Lelie H, Hoogsteden HC, Verbrugh HA, de Marie S; International Symposium on Infections in the Immunocompromised Host.

Tenth Int Symp Infect Immunocompromised Host 21 24 June 1998 Davos Switz Int Symp Infect Immunocompromised Host 10th 1998 Davos Switz. 1998 Jun 21-24; 10: (abstract no. 100).

University Hospital Dijkzigt, Rotterdam, The Netherlands.

Objective: To determine whether treatment with a high dose of AmBisome results in a better outcome of neutropenia-associated invasive fungal infections. Methods: In a randomized multicenter study, we compared AmBisome 5 mg/kg to amphotericin B (AmB) 1 mg/kg in the treatment of neutropenia associated invasive fungal infections. Results: Of 106 tentatively included patients (all evaluated for toxicity), 66 were definitely enrolled and analyzed for efficacy: 9 documented fungemia, 17 otherwise documented invasive mould infections and 40 suspected pulmonary aspergillosis. Thirty-two patients had been randomized to AmBisome, 34 to AmB. After completion, in the AmBisome arm 14 patients had a complete response, 7 a partial response and 11 a failure as compared to 6, 13 and 15 patients treated with AmB (P=0.09); P=0.03 for complete responders. A trend to favorable results for AmBisome was found at day 14, when patients with documented fungal infections or patients with pulmonary aspergillosis were evaluated (P=0.05 and P=0.096 respectively). Mortality rates were less in patients treated with AmBisome: 7/32 versus 13/34 (adjusted for malignancy status, P=0.03). More patients on AmB had a >100% increase of their baseline serum creatinine (P<0.001). Conclusion: In patients with neutropenia-associated invasive fungal infections AmBisome 5 mg/kg is superior to AmB 1 mg/kg with respect to efficacy and safety. AmBisome could be the therapy of choice, especially in patients with progressive malignancy.

Publication Types:

• Meeting Abstracts

Keywords:

• AmBisome
• Amphotericin B
• Aspergillosis, Allergic Bronchopulmonary
• Deoxycholic Acid
• Drug Combinations
• Fat Emulsions, Intravenous
• Fungemia
• Humans
• Mycoses
• Neutropenia
• amphotericin B-deoxycholate
• drug therapy
• therapy

Other ID:

• 20710031

UI: 102195055

From Meeting Abstracts