Tehran University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! On (X network) By
Liposomal Amphotericin for Secondary Prophylaxis: A Systematic Review and Meta-Analysis Publisher Pubmed



Javandoust Gharehbagh F1 ; Roshanzamiri S2 ; Farjami M3 ; Hatami F1, 4 ; Lotfollahi L5 ; Kazeminia N6 ; Hatami F1, 4 ; Shokouhi S1, 4 ; Alavi Darazam I1, 4, 7
Authors
Show Affiliations
Authors Affiliations
  1. 1. Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  2. 2. Clinical Pharmacy Specialist, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  3. 3. Department of Biostatics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  4. 4. Department of Infectious Diseases and Tropical Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  5. 5. Department of Nephrology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  6. 6. Clinical Trials and Pharmacovigilance Department, Food and Drug Administration, Tehran, Iran
  7. 7. Research Center for Antibiotic Stewardship and Antimicrobial Resistance, Tehran University of Medical Sciences, Tehran, Iran

Source: Journal of Oncology Pharmacy Practice Published:2024


Abstract

Introduction: This systematic review and meta-analysis aimed to determine the safety of liposomal amphotericin B (L-AMB) compared to other antifungal agents for secondary prophylaxis. Method: We conducted a comprehensive search across international databases and reference lists of articles to compile all relevant published evidence evaluating the efficacy and safety of L-AMB versus other antifungals (NLAMB) for secondary prophylaxis against invasive fungal infections. Pooled estimates were calculated after data transformation to evaluate mortality, breakthrough infections, and the frequency of adverse effects, including hypokalemia and nephrotoxicity. Comparisons of breakthrough fungal infection and mortality between the L-AMB and NLAMB groups were performed. Result: We identified 10 studies. The cumulative frequency of patients using L-AMB was 148, compared to 341 patients in the NLAMB group. The mortality rates in the L-AMB and NLAMB groups were 10% and 0%, respectively. However, based on the odds ratio, the mortality in the L-AMB group was lower than that in the NLAMB group. No significant difference was observed in breakthrough invasive fungal infections between the L-AMB and NLAMB groups. The frequencies of nephropathy and hypokalemia in the L-AMB group were 36% and 18%, respectively. Conclusion: Our findings indicate a lower incidence of mortality in the L-AMB group compared to the NLAMB group. No statistically significant difference was observed in the incidence of breakthrough infection between the two groups. L-AMB administration is associated with nephropathy and hypokalemia. However, the refusal to continue treatment due to adverse effects is not significantly high. © The Author(s) 2024.
Related Docs
1. Clinical Epidemiology of Pulmonary Aspergillosis in Hospitalized Patients and Contribution of Cyp51a, Yap1, and Cdr1b Mutations to Voriconazole Resistance in Etiologic Aspergillus Species, European Journal of Clinical Microbiology and Infectious Diseases (2023)
2. Invasive Fungal Infections in Hematologic Malignancies: Incidence, Management, and Antifungal Therapy, Journal of Research in Medical Sciences (2023)
3. Oropharyngeal Candida Colonization in Patients With Acute Myeloid Leukemia, Frontiers in Dentistry (2020)
Experts (# of related papers)
View all Related Experts
Mohammadreza Salehi (1)
Shiva Shirazian (1)