scholarly journals Efficacy of Topical Liposomal Amphotericin B versus Intralesional Meglumine Antimoniate (Glucantime) in the Treatment of Cutaneous Leishmaniasis

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Pouran Layegh ◽  
Omid Rajabi ◽  
Mahmoud Reza Jafari ◽  
Parisa Emamgholi Tabar Malekshah ◽  
Toktam Moghiman ◽  
...  
Keyword(s):  
Side Effects ◽  
Cutaneous Leishmaniasis ◽  
Amphotericin B ◽  
Liposomal Amphotericin ◽  
Liposomal Amphotericin B ◽  
Attractive Alternative ◽  
Intention To Treat ◽  
Treatment Side Effects ◽  
Significant Difference ◽  
Clinical Responses

Background. Topical treatment of cutaneous leishmaniasis is an attractive alternative avoiding toxicities of parenteral therapy while being administered through a simple painless route. Recently liposomal formulations of amphotericin B have been increasingly used in the treatment of several types of leishmaniasis.Aims. The efficacy of a topical liposomal amphotericin B formulation was compared with intralesional glucantime in the treatment of cutaneous leishmaniasis.Methods. From 110 patients, the randomly selected 50 received a topical liposomal formulation of amphotericin B into each lesion, 3–7 drops twice daily, according to the lesion's size and for 8 weeks. The other group of 60 patients received intralesional glucantime injection of 1-2 mL once a week for the same period. The clinical responses and side effects of both groups were evaluated weekly during the treatment course.Results. Per-protocol analysis showed no statistically significant difference between the two groups (, 95% confidence interval (0.632–4.101)). Moreover, after intention-to-treat analysis, the same results were seen (, 95% (0.560–2.530)). Serious post treatment side effects were not observed in either group.Conclusions. Topical liposomal amphotericin B has the same efficacy as intralesional glucantime in the treatment of cutaneous leishmaniasis.

Antifungal Prophylaxis (AFP) for Patients (Pts) with Acute Myelogenous Leukemia (AML) and High-Risk Myelodysplastic Syndrome (HR-MDS) Undergoing Intensive Chemotherapy: An Experience with 730 Pts.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 3102-3102 ◽  
Author(s):  
Gloria Mattiuzzi ◽  
Hagop Kantarjian ◽  
Jennifer Ho ◽  
Guillermo Garcia-Manero ◽  
Jorge Cortes
Keyword(s):  
Early Intervention ◽  
Side Effects ◽  
High Risk ◽  
Amphotericin B ◽  
Liposomal Amphotericin ◽  
Antifungal Prophylaxis ◽  
Myelogenous Leukemia ◽  
Liposomal Amphotericin B ◽  
Intensive Chemotherapy ◽  
Significant Difference

Abstract Abstract 3102 Poster Board III-39 Despite the advances in the development of antifungal agents, invasive fungal infections (IFI) remain a significant threat to patients with hematologic malignancies. The importance of early intervention for patients at high-risk for IFI has been widely discussed in several publications; however, the question of whether an early intervention such as prophylaxis is better than empiric or pre-emptive treatment still remains unanswered. Antifungal prophylaxis continues to be routinely used at MDACC for AML and HR-MDS patients. An ideal AFP regimen should be effective, safe, and uncomplicated for the patients. In the search of this ideal regimen, we have explored several options, including different type of drugs and various delivery schedules. Hereby, we report our experience since September 1997 to August 2009 with 730 AML and HR-MDS patients who received AFP for intensive chemotherapy. Proven IFI were defined as per the EORTC criteria. The following regimens were studied: Amphotericin B Lipid Complex (ABLC): 2.5 mg/kg IV three times/week; Liposomal Amphotericin B (AMBI 3TIW): 3 mg/kg IV three times/week; Fluconazole 400 mg (tab) /d + Itraconazole:200 mg (caps) /d (F + I); IV Itraconazole (IV ITRA):200 mg BID X 2 d, then 200 mg IV/d; Caspofungin (CASPO):50 mg IV /d; Voriconazole (IV VORI):400 mg IV BID x 2 d, then 300 mg IV BID; Liposomal Amphotericin B (AMBI 9/W): 9 mg/kg IV once per week; and Voriconazole (PO VORI ): 400 mg BID PO x 1 day, followed by 200 mg PO BID. Patients received ABLC, IV ITRA, F+I, AMBI 3TIW and CASPO since day 1 of IC until IC response was assessed. Pt on IV VORI, AMBI 3TIW and PO VORI started AFP within 24 hours after the last dose of IC until IC response was assessed. There were no significant differences among the pts in the 8 regimens with regards to age, gender, diagnosis, cytogenetics, performance status, presence of no fungal infection at start IC and stayed in protected environment. Table 1 shows our results. Although none of the pts receiving Voriconazole (IV or PO) developed proven IFI, all comparisons of efficacy among the AFP regimens were not significant (p= 0.291). None of the patients on AMBI 3TIW and either VORI had mold infections. There was a significant difference in the number of side effects among the 8 groups (p = 0.03). CASPO and PO VORI were the less toxic regimens. In addition, PO VORI was significantly less toxic than IV VORI (p=0.031). ABLC (N=131) AMBI 3TIW (N=69) F+I (N=67) IV ITRA (N=225) CASPO (N=106) VORI IV (N=61) AMBI 9/w (N=27) PO VORI (N=38) Breakthrough proven IFI n (%) 7(5) 3(4) 3(5) 17(8) 7(7) 0 2 (7) 0 –Yeast 2 3 1 11 3 0 1 0 –Mold 5 0 2 6 4 0 1 0 Drug-related side effects (%) 18 14 7 10 4 21 12 5 We conclude that PO VORI is safe, efficacious and easy to administer to the patients for the prevention of IFI in pts with AML and HR-MDS undergoing IC. CASPO is a safe alternative. Disclosures No relevant conflicts of interest to declare.

Efficacy of Early Administration of Liposomal Amphotericin B in Patients with Septic Shock: A Nationwide Observational Study

2020 ◽  
Author(s):  
Masato Tashiro ◽  
Takahiro Takazono ◽  
Yuki Ota ◽  
Tomotaro Wakamura ◽  
Akinori Takahashi ◽  
...  
Keyword(s):  
Septic Shock ◽  
Amphotericin B ◽  
Liposomal Amphotericin ◽  
Fungal Infections ◽  
Survival Rates ◽  
Liposomal Amphotericin B ◽  
National Database ◽  
Shock Onset ◽  
Significant Difference ◽  
Nationwide Observational Study

Abstract To determine the most suitable time to initiate liposomal amphotericin B (L-AMB) treatment in patients with invasive fungal infections, patients with septic shock treated with L-AMB were identified from the Japanese Diagnosis Procedure Combination national database to determine their survival rates following septic shock onset, mortality during shock, and shock cessation period. We identified 141 patients administered L-AMB: 60 patients received treatment on the day of septic shock onset (early L-AMB group), whereas 81 patients received treatment after the onset (delayed L-AMB group). Survival rates after septic shock onset were higher in the early L-AMB group than in the delayed L-AMB group (4 weeks: 68.4% vs 57.9%, P=0.197; 6 weeks: 62.2% vs 44.5%, P=0.061; 12 weeks: 43.4% vs 35.0%, P=0.168, respectively). Mortality during septic shock was significantly lower in the early L-AMB group than in the delayed L-AMB group (13% vs 42%, P<0.001), with a significant difference confirmed after adjusting for confounding factors (odds ratio: 0.240, 95% confidence interval: 0.096-0.601, P=0.002). Septic shock cessation period was shorter in the early L-AMB group than in the delayed L-AMB group (7.0±7.0 days vs 16.5±15.4 days, P<0.001). L-AMB administration at septic shock onset could be associated with early shock cessation and decreased mortality.

Cutaneous leishmaniasis in a Japanese returnee from West Africa successfully treated with liposomal amphotericin B

2011 ◽  
Vol 38 (11) ◽  
pp. 1062-1065 ◽  
Author(s):  
Misaki ONO ◽  
Kenzo TAKAHASHI ◽  
Kiyohito TAIRA ◽  
Hirosi UEZATO ◽  
Saori TAKAMURA ◽  
...  
Keyword(s):  
West Africa ◽  
Cutaneous Leishmaniasis ◽  
Amphotericin B ◽  
Liposomal Amphotericin ◽  
Liposomal Amphotericin B

scholarly journals Local Skin Inflammation in Cutaneous Leishmaniasis as a Source of Variable Pharmacokinetics and Therapeutic Efficacy of Liposomal Amphotericin B

2018 ◽  
Vol 62 (10) ◽  
Author(s):  
Gert-Jan Wijnant ◽  
Katrien Van Bocxlaer ◽  
Amanda Fortes Francisco ◽  
Vanessa Yardley ◽  
Andy Harris ◽  
...  
Keyword(s):  
Cutaneous Leishmaniasis ◽  
Amphotericin B ◽  
Liposomal Amphotericin ◽  
Skin Inflammation ◽  
Skin Lesions ◽  
Disease Stage ◽  
Liposomal Amphotericin B ◽  
Local Skin ◽  
Content Type ◽  
Tissue Inflammation

ABSTRACTDisfiguring skin lesions caused by several species of theLeishmaniaparasite characterize cutaneous leishmaniasis (CL). Successful treatment of CL with intravenous (i.v.) liposomal amphotericin B (LAmB) relies on the presence of adequate antibiotic concentrations at the dermal site of infection within the inflamed skin. Here, we have investigated the impact of the local skin inflammation on the pharmacokinetics (PK) and efficacy of LAmB in two murine models of localized CL (Leishmania majorandLeishmania mexicana) at three different stages of disease (papule, initial nodule, and established nodule). Twenty-four hours after the administration of one 25 mg/kg of body weight LAmB (i.v.) dose to infected BALB/c mice (n= 5), drug accumulation in the skin was found to be dependent on the causative parasite species (L. major>L. mexicana) and the disease stage (papule > initial nodule > established nodule > healthy skin). Elevated tissue drug levels were associated with increased vascular permeability (Evans blue assay) and macrophage infiltration (histomorphometry) in the infected skin, two pathophysiological parameters linked to tissue inflammation. After identical treatment of CL in the two models with 5 × 25 mg/kg LAmB (i.v.), intralesional drug concentrations and reductions in lesion size and parasite load (quantitative PCR [qPCR]) were all ≥2-fold higher forL. majorthan forL. mexicana. In conclusion, drug penetration of LAmB into CL skin lesions could depend on the disease stage and the causativeLeishmaniaspecies due to the influence of local tissue inflammation.

Atypical multifocal cutaneous leishmaniasis in an immunocompetent patient treated by liposomal amphotericin B

2005 ◽  
Vol 51 (5) ◽  
pp. e261-e264 ◽  
Author(s):  
A. Paradisi ◽  
R. Capizzi ◽  
A. Zampetti ◽  
I. Proietti ◽  
C. De Simone ◽  
...  
Keyword(s):  
Cutaneous Leishmaniasis ◽  
Amphotericin B ◽  
Liposomal Amphotericin ◽  
Immunocompetent Patient ◽  
Liposomal Amphotericin B
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