Clinical Study of the Efficacy and Safety of Liposomal Amphotericin B for the Treatment of Fungal Infections in Non-neutropenic Patients

抄録

Liposomal amphotericin B (L-AMB) is reported in Japan to be less effective and not as safe for treating severe fungal infections in non-neutropenic patients as in neutropenic patients. Therefore, we evaluated the clinical efficacy and safety of L-AMB as an antifungal agent in non-neutropenic patients. The efficacy of L-AMB administered intravenously in patients with severe fungal infections was retrospectively investigated by reviewing medical records from November 2007 to July 2010. The records of 18 eligible adult patients were analyzed according to the L-AMB dose they received: standard (2.5mg/kg/day; n=5) and high (>2.5mg/kg/day; n=13). The average age of the standard- and high-dosage group was 71.4 and 60.3 years, respectively. The 30-day survival rate in the standard- and high-dosage group was 20% (n=1) and 76.9% (n=10), respectively (P=0.047). A significant antipyretic effect was observed in the high-dosage group (P=0.001). There was no relationship between the dosage of L-AMB and any side effect. By carrying out the treatment according to the information provided at the time of administration, no cases were discontinued because of side effects. A high dosage of L-AMB is more effective than the standard dosage and both dosages are well-tolerated in non-neutropenic patients.