Lowry C M, Marty F M, Vargas S O, Lee J T, Fiumara K, Deykin A, Baden L R
Department of Pharmacy, Brigham & Women's Hospital, Boston, MA 02115, USA.
Transpl Infect Dis. 2007 Jun;9(2):121-5. doi: 10.1111/j.1399-3062.2007.00209.x.
Nebulized amphotericin B deoxycholate (AmBd) has been used to prevent invasive pulmonary aspergillosis after lung transplantation.
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.
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.
In lung transplant recipients, both inhaled AmBd and L-AmB were safe and well tolerated over a large number of medication exposures.
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。
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。
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。
在肺移植受者中，大量用药情况下，吸入AmBd和L-AmB均安全且耐受性良好。
