Use of liposomal amphotericin B in critically ill patients: A retrospective, multicenter, clinical study

The clinical use of liposomal amphotericin B in 179 patients admitted to 30 medical-surgical Intensive Care Units (ICUs) treated with this agent in 2006 was analyzed. Invasive fungal infections were proven, probable and possible in 44%, 16%, and 25% of cases, respectively. Fungi isolated were Candida albicans (38%), non-albicans Candida spp. (15%) and Aspergillus spp. (7%). The mean duration of treatment was 15 days (mean dose 3.7 mg/kg/day). The drug was used as rescue treatment after fluconazole or caspofungin in 47% of patients and as firstline in 52% with a satisfactory clinical response in 54% of cases (72.6% with proven infection). Microbiological eradication was achieved in 68% of cases. Adverse events occurred in 51 patients but were severe in only 4. The use of liposomal amphotericin B both as firstline and rescue treatment and mainly for proven invasive fungal infection was associated with a high rate of satisfactory clinical response. © E.S.I.F.T. srl.