雾化脂质体两性霉素B制剂与脱氧胆酸盐两性霉素B制剂预防肺移植后侵袭性真菌感染的安全性：一项回顾性研究

Safety of aerosolized liposomal versus deoxycholate amphotericin B formulations for prevention of invasive fungal infections following lung transplantation: a retrospective study.

作者信息

Lowry C M, Marty F M, Vargas S O, Lee J T, Fiumara K, Deykin A, Baden L R

机构信息

Department of Pharmacy, Brigham & Women's Hospital, Boston, MA 02115, USA.

出版信息

Transpl Infect Dis. 2007 Jun;9(2):121-5. doi: 10.1111/j.1399-3062.2007.00209.x.

DOI:10.1111/j.1399-3062.2007.00209.x

PMID:17461997

Abstract

BACKGROUND

Nebulized amphotericin B deoxycholate (AmBd) has been used to prevent invasive pulmonary aspergillosis after lung transplantation.

METHODS

In this retrospective study we compared the safety and tolerability of nebulized AmBd and nebulized liposomal amphotericin B (L-AmB) in 38 consecutive lung transplant recipients. Progress notes, medication administration records, microbiology, and pulmonary function reports were reviewed. Histologic sections from lung tissue were examined. Plasma amphotericin B levels were measured.

RESULTS

A total of 1206 doses of AmBd and 1149 doses of L-AmB were administered. Eighteen patients received AmBd only, 11 received L-AmB only, and 9 received the medications sequentially. The total number of complaints vs. the number of doses administered was 1.0% for AmBd-treated patients and 1.2% for L-AmB-treated patients. No differences were observed between the treatment groups on lung biopsy specimens. Plasma amphotericin B levels were <0.2-0.9 microg/mL in AmBd-treated patients and <0.2 microg/mL in L-AmB-treated patients.

CONCLUSIONS

In lung transplant recipients, both inhaled AmBd and L-AmB were safe and well tolerated over a large number of medication exposures.

摘要

背景

雾化两性霉素B脱氧胆酸盐（AmBd）已被用于预防肺移植术后侵袭性肺曲霉病。

方法

在这项回顾性研究中，我们比较了38例连续肺移植受者雾化AmBd和雾化脂质体两性霉素B（L-AmB）的安全性和耐受性。回顾了病程记录、用药记录、微生物学和肺功能报告。检查了肺组织的组织学切片。测量了血浆两性霉素B水平。

结果

共给予1206剂AmBd和1149剂L-AmB。18例患者仅接受AmBd，11例仅接受L-AmB，9例先后接受这两种药物。AmBd治疗组的总投诉次数与给药剂量数之比为1.0%，L-AmB治疗组为1.2%。两组在肺活检标本上未观察到差异。AmBd治疗组患者血浆两性霉素B水平<0.2 - 0.9μg/mL，L-AmB治疗组患者血浆两性霉素B水平<0.2μg/mL。