Comparison of the safety and cost-effectiveness of nebulized liposomal amphotericin B and amphotericin B deoxycholate for antifungal prophylaxis after lung transplantation
Copyright © 2024 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved..
INTRODUCTION: Fungal infection after lung transplantation can lead to poor clinical outcome, for which lung transplant recipients require prophylaxis. One of the antifungal agents used after lung transplantation is nebulized amphotericin B (AMB). Nebulized AMB causes adverse events such as dyspnea and airway irritation, and long-term use leads to high economic costs. So far, prophylactic regimens employing AMB deoxycholate (AMB-d) and liposomal AMB (L-AMB) have been developed. This study compared the efficacy, safety, and cost of AMB-d and L-AMB.
PATIENTS AND METHODS: Patients who underwent lung transplantation at Kyoto University Hospital from January 2021 to May 2023 were included in this study. Thirty-three patients received nebulized AMB-d, whereas 29 received nebulized L-AMB.
RESULTS: Both regimens maintained comparable prophylactic efficacy regarding the development of fungal infection in the AMB-d and L-AMB groups (3.0% vs. 3.4%, P = 0.877). Patients treated with nebulized L-AMB experienced fewer respiratory-related adverse reactions than those treated with nebulized AMB-d (6.9% vs. 30.3%, P < 0.05), leading to a longer treatment duration with L-AMB than with AMB-d. Additionally, the daily cost of administering L-AMB was lower than that of administering AMB-d (3609 Japanese yen vs. 1792.3 Japanese yen, P < 0.05).
DISCUSSION: These results suggest that nebulized L-AMB is safer and more cost-effective than nebulized AMB-d, with comparable efficacy.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy - (2024) vom: 12. Feb. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Umemura, Keisuke [VerfasserIn] |
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| Links: |
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| Themen: |
Fungal prophylaxis |
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| Anmerkungen: |
Date Revised 15.02.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1016/j.jiac.2024.02.010 |
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| PPN (Katalog-ID): |
NLM368450090 |
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| 100 | 1 | |a Umemura, Keisuke |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Comparison of the safety and cost-effectiveness of nebulized liposomal amphotericin B and amphotericin B deoxycholate for antifungal prophylaxis after lung transplantation |
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| 520 | |a Copyright © 2024 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved. | ||
| 520 | |a INTRODUCTION: Fungal infection after lung transplantation can lead to poor clinical outcome, for which lung transplant recipients require prophylaxis. One of the antifungal agents used after lung transplantation is nebulized amphotericin B (AMB). Nebulized AMB causes adverse events such as dyspnea and airway irritation, and long-term use leads to high economic costs. So far, prophylactic regimens employing AMB deoxycholate (AMB-d) and liposomal AMB (L-AMB) have been developed. This study compared the efficacy, safety, and cost of AMB-d and L-AMB | ||
| 520 | |a PATIENTS AND METHODS: Patients who underwent lung transplantation at Kyoto University Hospital from January 2021 to May 2023 were included in this study. Thirty-three patients received nebulized AMB-d, whereas 29 received nebulized L-AMB | ||
| 520 | |a RESULTS: Both regimens maintained comparable prophylactic efficacy regarding the development of fungal infection in the AMB-d and L-AMB groups (3.0% vs. 3.4%, P = 0.877). Patients treated with nebulized L-AMB experienced fewer respiratory-related adverse reactions than those treated with nebulized AMB-d (6.9% vs. 30.3%, P < 0.05), leading to a longer treatment duration with L-AMB than with AMB-d. Additionally, the daily cost of administering L-AMB was lower than that of administering AMB-d (3609 Japanese yen vs. 1792.3 Japanese yen, P < 0.05) | ||
| 520 | |a DISCUSSION: These results suggest that nebulized L-AMB is safer and more cost-effective than nebulized AMB-d, with comparable efficacy | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Fungal prophylaxis | |
| 650 | 4 | |a Lung transplantation | |
| 650 | 4 | |a Nebulized amphotericin B deoxycholate | |
| 650 | 4 | |a Nebulized liposomal amphotericin B | |
| 650 | 4 | |a Pharmacoeconomics | |
| 700 | 1 | |a Katada, Yoshiki |e verfasserin |4 aut | |
| 700 | 1 | |a Nakagawa, Shunsaku |e verfasserin |4 aut | |
| 700 | 1 | |a Hira, Daiki |e verfasserin |4 aut | |
| 700 | 1 | |a Yutaka, Yojiro |e verfasserin |4 aut | |
| 700 | 1 | |a Tanaka, Satona |e verfasserin |4 aut | |
| 700 | 1 | |a Ohsumi, Akihiro |e verfasserin |4 aut | |
| 700 | 1 | |a Nakajima, Daisuke |e verfasserin |4 aut | |
| 700 | 1 | |a Date, Hiroshi |e verfasserin |4 aut | |
| 700 | 1 | |a Nagao, Miki |e verfasserin |4 aut | |
| 700 | 1 | |a Terada, Tomohiro |e verfasserin |4 aut | |
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