Liposomal amphotericin for secondary prophylaxis: A systematic review and meta-analysis

被引:0
作者
Gharehbagh, Farid Javandoust [1 ]
Roshanzamiri, Soheil [2 ]
Farjami, Mohammad [3 ]
Hatami, Firouze [1 ,4 ]
Lotfollahi, Legha [5 ]
Kazeminia, Neda [6 ]
Hatami, Fatemeh [1 ]
Shokouhi, Shervin [1 ,4 ]
Darazam, Ilad Alavi [7 ]
机构
[1] Shahid Beheshti Univ Med Sci, Infect Dis & Trop Med Res Ctr, Tehran, Iran
[2] Shahid Beheshti Univ Med Sci, Clin Pharm Specialist, Tehran, Iran
[3] Shahid Beheshti Univ Med Sci, Fac Paramed Sci, Dept Biostat, Tehran, Iran
[4] Shahid Beheshti Univ Med Sci, Loghman Hakim Hosp, Dept Infect Dis & Trop Med, Tehran, Iran
[5] Shahid Beheshti Univ Med Sci, Loghman Hakim Hosp, Dept Nephrol, Tehran, Iran
[6] Clin Trials & Pharmacovigilance Dept, Food & Drug Adm, Tehran, Iran
[7] Loghman Hakim Hosp, Dept Infect Dis, Makhsoos St,South Kargar Ave, Tehran, Iran
关键词
Liposomal amphotericin B; secondary prophylaxis; invasive fungal infection; IFIs; INVASIVE FUNGAL-INFECTIONS; STEM-CELL TRANSPLANT; ANTIFUNGAL PROPHYLAXIS; ASPERGILLOSIS; STRATEGIES; RECIPIENTS; THERAPY;
D O I
10.1177/10781552241241317
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
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.
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页码:919 / 929
页数:11
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