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Safety of Inhaled Amphotericin B Lipid Complex as Antifungal Prophylaxis in Lung Transplant Recipients.

Publication ,  Journal Article
Huggins, JP; Pease, R; Stanly, K; Workman, A; Reynolds, J; Alexander, BD
Published in: Antimicrob Agents Chemother
June 21, 2022

Inhaled formulations of amphotericin B are the most widely used antifungal prophylactic agents in lung transplant recipients, yet there are limited data on their safety. We performed a single-center retrospective cohort study of 603 consecutive patients who underwent lung transplantation between 2012 and 2017 and received antifungal prophylaxis with inhaled amphotericin B lipid complex (iABLC) from the day of transplantation until hospital discharge. Of 603 patients, 600 (99.5%) received ≥1 dose of iABLC, and 544 (90.2%) completed the recommended prophylactic course. In total, 4,128 iABLC doses (median, 5; range, 1 to 48 per patient) were administered; 24 patients received >3 months of therapy. Only one (0.2%) patient discontinued therapy due to a drug-attributable adverse event. During the first posttransplant year, 80 (13.3%) patients died (median time to death, 171 days; interquartile range [IQR], 80 to 272 days), and 3,352 (median, 6 per patient) lung biopsies were performed; 414 (68.7%) patients developed biopsy-proven acute cellular rejection. One-year adverse events in our cohort of lung transplant recipients treated with iABLC during transplant hospitalization matched national outcomes for rejection, graft loss, and death. iABLC is a safe and well-tolerated antifungal prophylactic agent in lung transplant recipients.

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Published In

Antimicrob Agents Chemother

DOI

EISSN

1098-6596

Publication Date

June 21, 2022

Volume

66

Issue

6

Start / End Page

e0028322

Location

United States

Related Subject Headings

  • Transplant Recipients
  • Retrospective Studies
  • Mycoses
  • Microbiology
  • Lung Transplantation
  • Lung
  • Humans
  • Antifungal Agents
  • Amphotericin B
  • 3214 Pharmacology and pharmaceutical sciences
 

Citation

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Huggins, J. P., Pease, R., Stanly, K., Workman, A., Reynolds, J., & Alexander, B. D. (2022). Safety of Inhaled Amphotericin B Lipid Complex as Antifungal Prophylaxis in Lung Transplant Recipients. Antimicrob Agents Chemother, 66(6), e0028322. https://doi.org/10.1128/aac.00283-22
Huggins, Jonathan P., Robert Pease, Kelly Stanly, Adrienne Workman, John Reynolds, and Barbara D. Alexander. “Safety of Inhaled Amphotericin B Lipid Complex as Antifungal Prophylaxis in Lung Transplant Recipients.Antimicrob Agents Chemother 66, no. 6 (June 21, 2022): e0028322. https://doi.org/10.1128/aac.00283-22.
Huggins JP, Pease R, Stanly K, Workman A, Reynolds J, Alexander BD. Safety of Inhaled Amphotericin B Lipid Complex as Antifungal Prophylaxis in Lung Transplant Recipients. Antimicrob Agents Chemother. 2022 Jun 21;66(6):e0028322.
Huggins, Jonathan P., et al. “Safety of Inhaled Amphotericin B Lipid Complex as Antifungal Prophylaxis in Lung Transplant Recipients.Antimicrob Agents Chemother, vol. 66, no. 6, June 2022, p. e0028322. Pubmed, doi:10.1128/aac.00283-22.
Huggins JP, Pease R, Stanly K, Workman A, Reynolds J, Alexander BD. Safety of Inhaled Amphotericin B Lipid Complex as Antifungal Prophylaxis in Lung Transplant Recipients. Antimicrob Agents Chemother. 2022 Jun 21;66(6):e0028322.

Published In

Antimicrob Agents Chemother

DOI

EISSN

1098-6596

Publication Date

June 21, 2022

Volume

66

Issue

6

Start / End Page

e0028322

Location

United States

Related Subject Headings

  • Transplant Recipients
  • Retrospective Studies
  • Mycoses
  • Microbiology
  • Lung Transplantation
  • Lung
  • Humans
  • Antifungal Agents
  • Amphotericin B
  • 3214 Pharmacology and pharmaceutical sciences