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Liposomal amphotericin B

Liposomal amphotericin B is a formulation of the antifungal drug amphotericin B encapsulated within lipid vesicles.
This delivery system enhances the drug's solubility, stability, and target specificity, while reducing its toxicity.
Liposomal amphotericin B is used to treat severe fungal infections, such as invasive candidiasis and aspergillosis, in immunocompromised patients.
The lipid formulation improves the drug's pharmacokinetic profile, allowing for more efficient delivery to infected tissues and organs.
PubCompare.ai's AI-powered platform can help researchers optimize protocols and identify the best products for studying liposomal amphotericin B, improving reproducibility and accuracy in their fungal infection research.

Most cited protocols related to «Liposomal amphotericin B»

1
Cost-Effectiveness Analysis of Caspofungin and L-Amphotericin B
Cited 5 times
A decision-analytic model (Fig. 1) was developed to estimate the cost-effectiveness of caspofungin (70 mg on day one and 50 mg once daily thereafter) vs. L-Amb (3 mg/kg per day for an average patient weighing 77 kg (based on data for UK patients).
Patients were differentiated according to the presence (branches P1–P6) or absence of baseline infection (branches P7–P12). A baseline infection was defined as the presence of a proven or probable infection on the first or second day of the antifungal treatment (11 (link)). Patients dying prior to 7 d on initial therapy were collapsed into two branches (P6 and P12), irrespective of premature discontinuation of therapy or clinical failure. This was conducted to reduce model complexity and since cause of death could not be ascertained. However, nephrotoxicity being a cost driver was estimated within patients that died. Therefore, our costing process took into consideration the incidence of nehprotoxicity amongst patients that died on initial therapy (P6 and P12). A patient that survived initial therapy (branches P1–P5 and P7–P11) could either continue their initial therapy (P1–P3 and P7–P9) or discontinue due to drug-related toxicity. Nephrotoxicity (P4 and P10) being a significant cost-driver was differentiated from other drug-related adverse events (P5 and P11).
A patient categorised as successful in branch P1 was defined as having complete resolution of baseline fungal infection, including resolution of their fever during the neutropenic period, no premature discontinuation of therapy due to drug-related toxicity, and survival for 7 d after completion of therapy. A patient categorised as successful in group P7 (those without a baseline infection) had resolution of fever during the neutropenic period and no breakthrough fungal infection (defined as absence of infection from day 3 onward) during therapy or within 7 d after the completion of therapy, no premature discontinuation of therapy due to drug-related toxicity, and survival for 7 d after completion of therapy. These definitions of success are in accordance with the five-component end point used in clinical trials on empirical antifungal treatments (6 (link), 8 (link), 9 (link), 12 (link), 13 (link)).
For pragmatic reasons, we assumed that a patient does not discontinue due to lack of efficacy, as most of these patients have been accounted for in other branches related to adverse clinical outcomes (P3, P6, P9, P12). An additional analysis of the trial by Walsh et al. (2004) supports this assumption (8 (link)). If a patient discontinued initial therapy due to toxicity, a switch to a second line antifungal drug took place (from caspofungin to L-Amb or vice versa). Mortality and costs of these second line antifungal drugs were also included in the model.
The following data were estimated to use within our model:
(1) Probability that the patient has a successful outcome, or dies on initial treatment. The conditional probabilities of efficacy, survival and discontinuation of initial therapy (Table 1) were based on additional analyses of the RCT which assessed the efficacy and safety of caspofungin compared with L-Amb in empirical therapy (8 (link)).
(2) Life years lost: the expected life years lost per treatment arm were calculated by multiplying the probability of death on first line treatment (P6/P12) and the mortality observed on second line treatment (P4–P5 and P10–P11) with the life expectancy based on the underlying condition of patients enrolled in the study.
The estimate for life years lost was based on the life expectancy of the underlying diagnoses. In the study by Walsh et al. (2004), 74% of the patients suffered from acute leukaemia, 11% from non-Hodgkin's lymphoma and 15% from other cancers. We used 1- and 5-yr UK survival data from 1998–2001 (National Statistics, Survival data England 1998–2001) to calculate life expectancy for each of these conditions (14 ). Survival probability for a patient with acute leukaemia was defined in the model according to figures reported within the acute myelogenous leukaemia (AML) trials of the Medical Research Council. Overall, this resulted in an average discounted life expectancy of 12.9 yr. For second line treatment, the probability of dying was assumed to be 24% (15–33%) based on the study by Maertens et al. (15 (link)) who evaluated patients with fungal infections who were intolerant or refractory to their first line antifungal agent.
(3) Quality adjusted life years (QALYs) lost: this was determined by multiplying life years lost in each treatment arm by the utility (or quality of life score) based on the underlying condition. QALY estimates were discounted at 3.5% per year according to UK requirements.
Each life year lost was valued with a weighted quality of life multiplier of 0.72 (0.50–0.94) in order to calculate the QALYs lost upon death. This utility value for the defined underlying conditions was based on the catalogue of preference scores 1997–2000 from the CEA Registry from the Harvard School of Public Health (http://www.hsph.harvard.edu). QALYs saved were determined as the difference between QALYs lost with caspofungin and L-Amb.
(4) The cost evaluation included: expected antifungal drug costs (first line and second line), other direct costs (hospitalisation costs + drug costs related to adverse events) and overall costs. Costs were expressed in 2005 British Pounds (1 pound = 1.80 US dollar).
Bruynesteyn K., Gant V., McKenzie C., Pagliuca T., Poynton C., Kumar R.N, & Jansen J.P. (2007). A cost-effectiveness analysis of caspofungin vs. liposomal amphotericin B for treatment of suspected fungal infections in the UK. European Journal of Haematology, 78(6), 532-539.
Publication 2007
2
Cryptococcal Meningitis Treatment Protocol
Cited 5 times
The study design has been described previously26 (link) and is provided in the full study protocol available as Supplementary Material at nejm.org. HIV-positive adults (≧18 years) with a first episode of cryptococcal meningitis, diagnosed by positive India Ink or cryptococcal antigen (CrAg lateral flow assay, IMMY, Norman, Oklahoma, USA) in CSF, were recruited from eight Hospitals: Princess Marina Hospital, Gaborone, Botswana; Queen Elizabeth Central Hospital, Blantyre and Kamuzu Central Hospital, Lilongwe, Malawi; Mitchells Plain Hospital and Khayelitsha Hospital, Cape Town, South Africa; Kiruddu National Referral Hospital, Kampala and Mbarara Regional Referral Hospital, Mbarara, Uganda; and Parirenyatwa Central Hospital, Harare, Zimbabwe. Participants were excluded if they had received more than two doses of either amphotericin or treatment dose fluconazole (≧800mg) prior to screening, declined consent or in cases of impaired capacity to consent had no legal representative to consent on their behalf, were pregnant, breast-feeding, taking contraindicated concomitant drugs, or had any previous adverse reaction to the study drugs. Late exclusion criteria, put in place to enable rapid enrolment of critically unwell participants pending baseline blood test results, were alanine transaminase (ALT) >5 times the upper limit of normal (>200 IU/L), polymorphonuclear leukocytes (PMNs) <500 x 106/L or platelets <50,000 x 106/L.
Jarvis J.N., Lawrence D.S., Meya D.B., Kagimu E., Kasibante J., Mpoza E., Rutakingirwa M.K., Ssebambulidde K., Tugume L., Rhein J., Boulware D.R., Mwandumba H.C., Moyo M., Mzinganjira H., Kanyama C., Hosseinipour M.C., Chawinga C., Meintjes G., Schutz C., Comins K., Singh A., Muzoora C., Jjunju S., Nuwagira E., Mosepele M., Leeme T., Siamisang K., Ndhlovu C.E., Hlupeni A., Mutata C., van Widenfelt E., Chen T., Wang D., Hope W., Boyer-Chammard T., Loyse A., Molloy S.F., Youssouf N., Lortholary O., Lalloo D.G., Jaffar S, & Harrison T.S. (2022). Single-Dose Liposomal Amphotericin B Treatment for Cryptococcal Meningitis. The New England journal of medicine, 386(12), 1109-1120.
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Publication 2022
Adult Alanine Transaminase Amphotericin Antigens Biological Assay Blood Platelets Cryptococcus Drug Reaction, Adverse Fluconazole Hematologic Tests HIV Seropositivity India ink Meningitis, Cryptococcal Neutrophil Pharmaceutical Preparations
3
Bundles for Invasive Candidiasis Management
Cited 4 times
The ACTIONs (Appropriate Candidal Treatment Implementation of Non-neutropenic strategies) Project Committee developed bundles based on key guideline recommendations6 (link)–8 for the diagnosis and treatment of non-neutropenic patients with invasive candidiasis in 2011. The ACTIONs Project is one of the activities of the Mycoses Forum supported by Pfizer Japan Inc. ACTIONs bundles consist of nine items to complete for candidaemia (Table 1). For the awareness of activities, briefing sessions targeting infection control doctors certified by the Japanese College of Infection Control Doctors were held in 11 geographical regions throughout Japan. Bundle checklists were available on the web site of the Mycoses Forum (http://www.mycoses.jp/actions_project/index.html#BUNDLE) and were printed and widely distributed. Data were entered into the bundle database locally or check sheets were sent to the central office of the Mycoses Forum between July 2011 and April 2012.

Bundle elements in patients with candidaemia

Bundles to be accomplished at the start of therapy

1. Removal of existing CVCs within 24 h of diagnosis

2. Initial appropriate selection of antifungals

3. Initial appropriate dosing of antifungals

Bundles to be accomplished after initiation of therapy

4. Ophthalmological examinations

5. Follow-up blood cultures until clearance of candidaemia

6. Assessment of clinical efficacy on the third to fifth day to consider necessity of alternative therapy

7. Appropriate choice of alternative antifungals

8. At least 2 weeks of therapy after documented clearance of Candida from bloodstream and resolution of attributable symptoms (prolonged therapy for candidaemia with organ involvement)

9. Step-down oral therapy for patients with favourable clinical course

Entry criteria were non-neutropenic patients >17 years old treated with antifungals for candidaemia with a positive culture for Candida spp. in blood samples. The appropriate selection and dosing regimen of antifungals were decided according to previously published guidelines6 (link)–8 (Table 2). If no clinical efficacy was obtained on the third to the fifth day, consideration of alternative therapy was recommended, such as a change to echinocandins or liposomal amphotericin B in patients to whom azoles were administered as initial therapy. Transition to fluconazole is recommended in clinically stable patients with infection due to Candida albicans.

Appropriate selection and dosing of antifungals in the bundles

AntifungalsAppropriate indicationStandard dosing
Echinocandinspatients with moderately severe to severe illnesscaspofungin: loading dose of 70 mg, then 50 mg dailymicafungin: 100–150 mg daily
infection due to C. glabrata and C. krusei
patients with candidaemia in whom CVCs cannot be removed
consider poor ocular penetration in ocular candidiasis
Fluconazolepatients who are less critically ill and who have no recent azole exposureloading dose of 800 mg, then 400 mg daily
infection due to C. parapsilosis and C. albicans
transition to fluconazole in clinically stable patients with infection due to C. albicans
Voriconazolealternative therapy6 mg/kg bid for two doses, then 3–4 mg/kg bid
step-down oral therapy
limitation of intravenous formulation in renal impairment
consider therapeutic drug monitoring
Itraconazolealternative therapy200 mg bid for 2 days, then 200 mg daily
limitation of intravenous formulation in renal impairment
Liposomal amphotericin Bpatients with severe sepsis/septic shock2.5–5.0 mg/kg daily
infection due to C. glabrata, C. krusei and C. guilliermondii
patients with candidaemia in whom CVCs cannot be removed
Amphotericin B deoxycholaterecommendation against use due to substantial renal and infusion-related toxicity—
Flucytosinecombination use with other antifungals25 mg/kg qid

bid, twice a day; qid, four times a day.

Clinical response was judged after the end of all treatment courses, and mortality was evaluated 28 days after the start of antifungal therapy. Treatment was considered to be successful if all attributable signs and symptoms associated with candidaemia had resolved. Treatment was considered to have failed if there was unresponsive infection after at least 5 days of therapy, or if relapse occurred. In patients with treatment failure of initial antifungals or unacceptable adverse events necessitating a change of initial antifungal therapy, overall treatment was judged to be successful if a favourable clinical response was obtained with alternative therapy.
We defined compliance as evidence that all bundle elements except ‘appropriate choice of alternative antifungals’ were completely fulfilled. As this item is indicated only for patients in whom antifungals were changed, we excluded this from the analysis of compliance. The element ‘removal of central venous catheters (CVCs)’ was included for the evaluation of compliance in patients with CVC placement. Missing data regarding the accomplishment of bundle elements were set as ‘fail’.
Clinical efficacy and mortality were evaluated according to the compliance. To identify the contribution of each element to improvement of clinical outcomes, the ORs of clinical success and mortality were adjusted for the following factors affecting clinical outcomes: surgery, chemotherapy for cancer, malnutrition, total parenteral nutrition, age >70 years, chronic renal failure/haemodialysis, severe illness, steroid/immunosuppressant use, mechanical ventilation, use of a CVC, malignancy, ICU stay, diabetes mellitus and isolation of non-albicans Candida. Bundle elements such as ‘third to fifth day follow-up’ and ‘2 weeks of antifungal therapy’ can only be achieved in patients who survive. To exclude deaths and dropouts before completion of bundle elements to be achieved after the start of therapy, we performed sub-population analysis in patients who survived >28 days after the start of antifungal therapy.
This study was approved by the institutional review board of Hyogo College of Medicine. The institutional review board waived the need for patients' informed consent. Ethics approval was the responsibility of each participating centre. If necessary, investigators obtained formal approval of the protocol by the regional ethics committee. The crude OR in univariate analysis was estimated for each variable by the χ2 test and potential confounders were examined by cross tabulation. The variables selected by univariate analysis (P < 0.1) were subsequently entered into a stepwise logistic regression model to estimate the magnitude of association (adjusted OR and 95% CI). The level of significance was set at P < 0.05. SPSS ver. 16 (SPSS Inc., Chicago, IL, USA) was used to perform these analyses.
Takesue Y., Ueda T., Mikamo H., Oda S., Takakura S., Kitagawa Y., Kohno S., Masuda A., Yoshida C., Yasunaga C., Yamashita C., Nakataki E., Ohyagi H., Yagi H., Johnai H., Murai H., Hanamoto H., Nakamura I., Sanada I., Tandai I., Kuroki J., Ogawa J., Kawahara K., Amino K., Nakajima K., Yoshimoto K., Takeda K., Nakamura K., Suzuki K., Yamada K., Aizawa M., Hashimoto M., Ogata M., Shirano M., Kawada M., Kaneda M., Yoshioka M., Okuda N., Sugita N., Kikuchi N., Fuke S., Tsuchihashi S., Sugitani S., Ikuta S., Honda S., Nei T., Iwamura T., Yagi T., Kaji T., Ichimiya Y., Kobayashi Y., Minamishima Y., Goto Y., Hatano Y., Nagao Y., Yamagishi Y., Sashihara J., Tsukamoto A., Kawaoka T, & Kobayashi M. (2014). Management bundles for candidaemia: the impact of compliance on clinical outcomes. Journal of Antimicrobial Chemotherapy, 70(2), 587-593.
Publication 2014
4
Implementing Antibiotic Stewardship Program in Hospital
Cited 3 times
In the preintervention period, “justification forms” stating indication for use of (colistin, polymyxin B, tigecycline, meropenem, ertapenem, doripenem, fosfomycin, vancomycin, aztreonam, and linezolid) were required to be completed within 24 hours by the treating doctor. These forms were submitted to the infection control team. The infection control team comprised a microbiologist, internal medicine physician, trained infection control nurses, and a medical administrator/physician. On receiving the justification forms, the infection control nurses collected relevant patient information and presented it to the team in a biweekly meeting for review of appropriateness. Feedback was provided via e-mail to the treating doctor based on the review by the infection. When indicated, de-escalation was recommended.
In February 2016, a formal ASP was created and included a physician/hospitalist, intensivist, microbiologists, clinical pharmacists, and an administrative champion. The ASP team reviewed and adapted content from the Infectious Diseases Society of America, Society for Healthcare Epidemiology of America, and the Centers for Disease Control and Prevention [9–11 (link)] for guiding principles of antibiotic stewardship. The ASP focused on postprescriptive audit with feedback and intervention and development of institutional guidelines. Updated institutional antibiograms were disseminated to all providers and were accessible on the hospital intranet. A list of “restricted” antimicrobials was generated based on previous antibiogram data (this included polymyxins B and E [colistin], carbapenems, glycopeptides, aztreonam, tigecycline, linezolid, fosfomycin, echinocandins, lipids/liposomal amphotericin B, and voriconazole). Double anaerobic coverage was targeted as a stewardship target as was appropriate dosing of polymyxins. To standardize dosing for colistin and polymyxin B, the ASP team established guidelines for loading dose and maintenance dose based on creatinine clearance [12 , 13 (link)].
Every weekday morning, data on patients who were receiving restricted antibiotics were obtained through the electronic medical record. Data abstracted from the electronic medical record included demographics, clinician notes, laboratory investigations, microbiology tests, imaging results, and drug details. The ASP team discussed these cases, the appropriateness of therapy for each case based on definitions stated in Table 1. The team defined appropriateness using the “5 Rs” or Right drug, Right indication, Right dose, Right frequency, and Right duration. References for appropriateness included Infectious Diseases Society of America practice guidelines [14–16 (link)], stewardship guidelines [17 (link)], and standard treatment recommendations of antimicrobial therapy [18–21 (link)].
The ASP team reviewed clinical charts every weekday. Appropriate use was encouraged with positive feedback to providers. Inappropriate use was discussed with providers and coupled with a stewardship recommendation, which was filed in the patient’s record and discussed with the care providers through phone or e-mail (Figure 1).
Singh S., Menon V.P., Mohamed Z.U., Kumar V.A., Nampoothiri V., Sudhir S., Moni M., Dipu T.S., Dutt A., Edathadathil F., Keerthivasan G., Kaye K.S, & Patel P.K. (2018). Implementation and Impact of an Antimicrobial Stewardship Program at a Tertiary Care Center in South India. Open Forum Infectious Diseases, 6(4), ofy290.
Publication 2018
Administrators Antibiogram Antibiotics Antibiotic Stewardship Aztreonam Carbapenems Clinical Pharmacists Colistin Communicable Diseases Creatinine Doripenem Echinocandins Ertapenem Fosfomycin Glycopeptides Hospitalists Infection Infection Control Linezolid Lipids liposomal amphotericin B Meropenem Microbicides Nurses Patients Pharmaceutical Preparations Physicians Polymyxin B Polymyxins Tigecycline Vancomycin Voriconazole
5
Oxidative Stress in Cutaneous Leishmaniasis
Cited 3 times
This study was approved by the Ethics Committee of the Gonçalo Moniz Research Center. Informed consent was obtained from all patients and healthy controls. CL was diagnosed in patients as described elsewhere [11 (link)], according to characteristic lesion morphology, positive skin test results, seropositivity to Leishmania antigen, and/or presence of parasites in the lesion. A total of 58 patients with LCL due to L. braziliensis (27 males; mean age [±SD], 29.6 ± 2.3 years) were recruited and treated in 2 outpatient clinics (Jequié and Jiquiriçá-BA, NE Brazil) covering the same rural area. Ten patients with LCL due to L. amazonensis (6 males; mean age [±SD], 38.8 ± 6 years) were recruited and treated at the Professor Edgar Santos University Hospital (Salvador-BA, NE Brazil). Plasma samples from patients with LCL were collected at diagnosis (before treatment). In addition, a paired sample was obtained from 13 patients at the time of definite clinical cure (range, 68–417 days). Patients with LCL (due to either L. braziliensis or L. amazonensis) received standard intravenous pentavalent antimony (Glucantime; Rhodia, 20 mg/kg/day for 20 days). Cure was defined by the complete scarring of lesions, without induration and relapse during 2 years of follow-up. Although all L. amazonensis–infected patients were cured within 90 days following a single treatment cycle, L. braziliensis–infected patients needed a mean (±SD) of 2.2 ± 0.2 treatment cycles over 190.5 ± 16.0 days to achieve cure, with treatment for 23 of 58 patients (39.7%) classified as failing (>2 cycles). Eight patients with DCL (3 males; mean age [±SD], 31.5 ± 7.1 years) infected with L. amazonensis were recruited and treated at the Presidente Dutra University Hospital–HUPD (São Luís-MA, NE Brazil). Patients with DCL had a mean disease duration (±SD) of 10.9 ± 2.1 years, during which several different therapeutic schemes (mean number [±SD] per patient, 2.7 ± 0.9, including liposomal amphotericin B and combinations of Glucantime, interferon γ, and pentamidine) were used, with no or only a transient clinical effect. Since DCL is a rare clinical manifestation, no samples from untreated patients (at diagnosis) were available for comparison. SOD1 plasma levels were quantified using a human SOD1 enzyme-linked immunosorbent assay kit (Calbiochem). RNA was extracted from lesion biopsy specimens from patients with LCL and those with DCL, as well as skin biopsy specimens from healthy controls, using Trizol, followed by an additional purification using RNeasy (QIAgen Benelux, Venlo, the Netherlands). Using in situ transcriptomics, we simultaneously quantified host and parasite RNAs in lesion biopsy specimens from patients with LCL and those with DCL, as well as skin biopsy specimens from healthy controls, by nCounter technology (NanoString, Seattle, WA), based on molecular bar coding of target RNA transcripts and digital detection at the femtomolar range, using direct hybridization, without reverse transcription or amplification [12 (link)]. Human SOD1, SOD2, SOD3, IFNA1, IFNA2, IFNA4, IFNB1, and L. braziliensis and L. amazonensis SOD1-5 messenger RNA (mRNA) levels were quantified in situ, in addition to mRNAs of several housekeeping genes (GUSB, G6PD, GAPDH, and HPRT1), for normalization, as well as leukocyte-specific genes (CD3, CD14, CD19, CD56, and CD45). Quantification of the parasite burden in vitro was performed as described elsewhere [9 (link)]. Briefly, monocyte-derived human macrophages were infected with L. amazonensis (MHOM/BR/87/BA125) and treated with SOD1 (Sigma) for 48 hours, followed by extensive washing, staining with hematoxylin/eosin, and counting of intracellular amastigotes (100 cells, with duplicate analysis for each sample). Parametric and nonparametric tests were performed according to Kolmogorov-Smirnov test for normality. For multiple comparisons, the Kruskal–Wallis test with the Dunn posttest and 1-way analysis of variance with a posttest for linear trend were used. For comparison between 2 groups, the F test, the Mann–Whitney U test, the t test, or the Wilcoxon test was used. To identify biomarkers, Receiver Operating Characteristic (ROC) curve analysis was used. All tests were 2 tailed, and differences were considered significant at P values of <.05.
Khouri R., Santos G.S., Soares G., Costa J.M., Barral A., Barral-Netto M, & Van Weyenbergh J. (2014). SOD1 Plasma Level as a Biomarker for Therapeutic Failure in Cutaneous Leishmaniasis. The Journal of Infectious Diseases, 210(2), 306-310.
Publication 2014

Most recents protocols related to «Liposomal amphotericin B»

1
Liposomal Amphotericin B Versus Clotrimazole for PV
The diagnosis of PV was initially made based on clinical grounds and Wood’s light examination. Mycologic confirmation was then performed through microscopic examination of scales soaked in 10% potassium hydroxide (KOH) during the first visit. For the subsequent KOH examination, patients were instructed not to bathe or use any antifungal agent for 2 days before the second sampling. Patients with two positive KOH smear results were randomly assigned to either the intervention group or the control group using a permuted block technique. To maintain blinding, the intervention medications were prepared by a researcher who was not involved in the study and were directly delivered to the patients. The intervention group applied liposomal amphotericin B topical gel (Sina Ampholish 0.4%, Exir Nano Sina Company), while the control group applied clotrimazole topical cream (Clotrimazole-Najo 1% cream, Najo Company) on their skin lesions twice a day for 14 days. Due to the different formulations of the antifungal agents (gel versus cream), the study was not blinded to the patients. Thus, blinding was maintained for the researchers. The patients’ data was coded with the letter A indicating the amphotericin group and the letter B representing clotrimazole, followed by a consecutive numerical assignment (A/B1, A/B2, etc.) to conceal the patients categorization and the intervention drug used.
Ghahartars M., Hosseini H., Khedri M, & Sadati M.S. (2024). Comparison of the Efficacies of Topical Liposomal Amphotericin B and Topical Clotrimazole in the Treatment of Pityriasis Versicolor. Dermatology Practical & Conceptual, 14(1), e2024083.
Publication 2024
2
Pharmacokinetic Modeling of Neglected Tropical Disease Drugs
Previously developed population pharmacokinetic models of miltefosine [29 (link)] and fexinidazole and its active metabolites M1 and M2 (internal report) were used to derive individual predicted pharmacokinetic concentrations, which were used as pharmacokinetic input to the model. For liposomal amphotericin B and SSG, a kinetic-pharmacodynamic approach was used assuming a one compartment model with first-order elimination, using the administered drug amounts and previously reported elimination half-lives of 6 hours for liposomal amphotericin B [32 (link)] and 2 hours for SSG [33 (link),34 (link)]. Direct and delayed sigmoidal Emax and linear models were evaluated to model drug-induced killing of parasites driven by individual predicted concentration-time curves for each drug.
Verrest L., Monnerat S., Musa A.M., Mbui J., Khalil E.A., Olobo J., Wasunna M., Chu W.Y., Huitema A.D., Schallig H.D., Alves F, & Dorlo T.P. (2024). Leishmania blood parasite dynamics during and after treatment of visceral leishmaniasis in Eastern Africa: A pharmacokinetic-pharmacodynamic model. PLOS Neglected Tropical Diseases, 18(4), e0012078.
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Publication 2024
3
Treatment Strategies for Leishmaniasis
As recommended by the Brazil Ministry of Health, the standard therapy was meglumine antimoniate (20 mg/kg) for 30 days for DL and 20 days for CL. However, DL is common in patients >50 years of age, and those patients should be treated with amphotericin B or miltefosine to reduce adverse reactions. Of the 202 study participants, 82 DL and all 101 CL patients were treated with meglumine antimoniate. We evaluated patients every 30 days until cure. We registered the number and size of lesions and noted appearance of new lesions, occurrence of mucosal disease, and adverse reactions at each visit. We defined cure as complete epithelization of all lesions without infiltrated borders 90 days after initiating therapy.
Age of >50 years, heart disease, and kidney failure are contraindications for the use of meglumine antimoniate. In this study, 19 DL patients did not receive meglumine antimoniate and were treated with available alternative drugs: 3 patients received deoxycholate amphotericin B (20–30 mg/kg weight; 6 patients received liposomal amphotericin B (35–40 mg/kg weight; 5 patients received miltefosine (2.5 mg/kg/d [maximum dose 150 mg/d] for 28 days); and 5 patients received miltefosine (same dosing) combined with meglumine antimoniate (20 mg/kg weight for 30 d). Patients who failed to respond to meglumine antimoniate received a second course of the same dose. Those who failed to respond to miltefosine or amphotericin B received liposomal amphotericin B (35 mg/kg weight).
Machado P.R., Lago A., Cardoso T.M., Magalhaes A., Carvalho L.P., Lago T., Carvalho A.M., Costa R, & Carvalho E.M. (2024). Disseminated Leishmaniasis, a Severe Form of Leishmania braziliensis Infection. Emerging Infectious Diseases, 30(3), 510-518.
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Publication 2024
4
Pediatric Pharmacokinetics of Liposomal Amphotericin B
This systematic review was conducted according to PRISMA guidelines.20 (link) All observational (both retrospective and prospective) and interventional studies that evaluated the PK/PD of L-amb in children and adolescents aged 0–18 years were eligible for inclusion in our study. Studies of L-amb not administered IV, and non-liposomal formulations were excluded. In addition, review articles, commentaries, editorials, animal studies and case series of fewer than five patients were excluded.
We searched PubMed and Embase for relevant studies from 1 January 1984 to 31 July 2023 using a combination of the following MeSH terms: (‘Amphotericin B)’ AND ‘(Drug monitoring’ OR ‘Pharmacokinetics’ OR ‘Pharmacodynamics’ OR ‘drug concentration’) AND (‘child’ OR ‘adolescent’). A human filter was applied, and only studies in the English language were included. See Tables S1 and S2 (available as Supplementary data at JAC Online) for the detailed search strategy.
Retrieved articles were uploaded to COVIDENCE (https://www.covidence.org/) and duplicates were removed. Titles and abstracts were screened for eligibility, followed by a full-text review of selected studies by independent reviewers (T.L., C.Y.Y., M.S. and B.R.). Discrepancies between reviewers were settled by discussion and a third reviewer (T.L. or J.W.C.A.). The reason for the study exclusion was documented during the full-text review. The reference lists of all included full-text articles were searched to identify any other eligible studies not captured in the search strategy.
Lai T., Yeo C.Y., Rockliff B., Stokes M., Kim H.Y., Marais B.J., McLachlan A.J, & Alffenaar J.W. (2024). Therapeutic drug monitoring of liposomal amphotericin B in children. Are we there yet? A systematic review. Journal of Antimicrobial Chemotherapy, 79(4), 703-711.
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Publication 2024
5
Topical Administration of Amphotericin B
AmB nebulization: nebulization of AmB at a dose 5 ~ 10 mg per administration was performed. The drug was dissolved in sterile water for injection to achieve a final concentration of 0.2 ~ 0.3% before application. The drug was inhaled 2 ~ 3 times per day.
Tracheoscopic instillation: Involved administering AmB at a dose of 5 ~ 25 mg per administration. The drug was dissolved in sterile water for injection to achieve a final concentration of 0.025 ~ 0.125% before application.
Intrapleural irrigation: AmB was administered at a dose of 5 ~ 25 mg per administration. The drug was dissolved in sterile water for injection to achieve a final concentration of 0.01 ~ 0.05% before application.
The main dosage forms of AmB include amphotericin B deoxycholate, amphotericin B lipid complex, liposomal amphotericin B, and others. Among the instructions of the above several drugs, only the instructions of deoxycholate amphotericin B have the usage of topical administration. The formulation for topical administration was deoxycholate amphotericin B in all cases.
Cui N, & Zhao J. (2024). Application and evaluation of topical amphotericin B for the treatment of respiratory fungal infections. BMC Infectious Diseases, 24, 439.
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Publication 2024

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1
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RPMI 1640 is a widely used cell culture medium formulated for the growth of a variety of cell types, including human and animal cells. It provides the necessary nutrients and components to support cell growth and proliferation in a controlled laboratory environment.
2
Ambisome by Gilead Sciences
Sourced in United States
AmBisome is a liposomal formulation of amphotericin B, a potent antifungal agent used to treat serious fungal infections. AmBisome is designed to enhance the delivery and distribution of amphotericin B to infected tissues, while potentially reducing certain side effects associated with the traditional formulation.
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L amb by Gilead Sciences
Sourced in United States, Ireland, Greece
L-AMB is a sterile, pyrogen-free, preservative-free, liposomal amphotericin B formulation. Amphotericin B is an antifungal agent with a broad spectrum of activity against many fungal pathogens.
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Rpmi 1640 medium by Merck Group
Sourced in United States, Germany, United Kingdom, Japan, Italy, China, France, Sao Tome and Principe, Switzerland, Austria, Australia, Spain, Macao, Belgium, Canada, Hungary, Brazil, Sweden, Ireland, India, Poland, Israel, Mexico, Denmark, Hong Kong, Czechia, Argentina, Portugal, Holy See (Vatican City State)
RPMI-1640 is a widely used cell culture medium formulation, developed at Roswell Park Memorial Institute. It is a complete and balanced medium designed to support the growth and maintenance of a variety of cell types, including human and animal cell lines. The medium contains essential nutrients, vitamins, amino acids, and other components necessary for cell proliferation and survival in in vitro cell culture applications.
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Synergy h1 hybrid reader by Agilent Technologies
Sourced in United States, Germany, Switzerland, Canada, United Kingdom
The Synergy H1 Hybrid Reader is a compact and versatile instrument designed for a wide range of microplate-based assays. It combines multiple detection modes, including absorbance, fluorescence, and luminescence, to provide a comprehensive analysis platform for life science research and drug discovery applications.
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Facsdiva software by BD
Sourced in United States, Germany, United Kingdom, Canada, France, Belgium, Australia, Italy, Spain, Switzerland, Netherlands, Finland, Japan, China, Jersey, Lao People's Democratic Republic
FACSDiva software is a user-friendly flow cytometry analysis and data management platform. It provides intuitive tools for data acquisition, analysis, and reporting. The software enables researchers to efficiently process and interpret flow cytometry data.
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Tolbutamide by Merck Group
Sourced in United States, Germany, United Kingdom
Tolbutamide is a pharmaceutical compound used as a laboratory reagent. It is a sulfonylurea drug that acts as an antidiabetic agent by stimulating insulin secretion from the pancreas. Tolbutamide is commonly used in research and development settings to study glucose homeostasis and insulin regulation.
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Dimethyl sulfoxide (dmso) by Merck Group
Sourced in United States, Germany, United Kingdom, China, Italy, Sao Tome and Principe, France, Macao, India, Canada, Switzerland, Japan, Australia, Spain, Poland, Belgium, Brazil, Czechia, Portugal, Austria, Denmark, Israel, Sweden, Ireland, Hungary, Mexico, Netherlands, Singapore, Indonesia, Slovakia, Cameroon, Norway, Thailand, Chile, Finland, Malaysia, Latvia, New Zealand, Hong Kong, Pakistan, Uruguay, Bangladesh
DMSO is a versatile organic solvent commonly used in laboratory settings. It has a high boiling point, low viscosity, and the ability to dissolve a wide range of polar and non-polar compounds. DMSO's core function is as a solvent, allowing for the effective dissolution and handling of various chemical substances during research and experimentation.
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Acetonitrile by Merck Group
Sourced in Germany, United States, Italy, India, China, United Kingdom, France, Poland, Spain, Switzerland, Australia, Canada, Brazil, Sao Tome and Principe, Ireland, Belgium, Macao, Japan, Singapore, Mexico, Austria, Czechia, Bulgaria, Hungary, Egypt, Denmark, Chile, Malaysia, Israel, Croatia, Portugal, New Zealand, Romania, Norway, Sweden, Indonesia
Acetonitrile is a colorless, volatile, flammable liquid. It is a commonly used solvent in various analytical and chemical applications, including liquid chromatography, gas chromatography, and other laboratory procedures. Acetonitrile is known for its high polarity and ability to dissolve a wide range of organic compounds.
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Phosphate buffered saline (pbs) by Merck Group
Sourced in United States, Germany, United Kingdom, Italy, Poland, Spain, France, Sao Tome and Principe, Australia, China, Canada, Ireland, Japan, Macao, Switzerland, India, Belgium, Denmark, Israel, Brazil, Austria, Portugal, Sweden, Singapore, Czechia, Malaysia, Hungary
PBS (Phosphate-Buffered Saline) is a widely used buffer solution in biological and medical research. It is a balanced salt solution that maintains a stable pH and osmotic pressure, making it suitable for a variety of applications. PBS is primarily used for washing, diluting, and suspending cells and biological samples.

More about "Liposomal amphotericin B"

Liposomal amphotericin B, also known as L-AMB or AmBisome, is a formulation of the antifungal medication amphotericin B encapsulated within lipid vesicles.
This delivery system enhances the drug's solubility, stability, and target specificity, while reducing its toxicity.
Liposomal amphotericin B is used to treat severe fungal infections, such as invasive candidiasis and aspergillosis, in immunocompromised patients.
The lipid formulation improves the drug's pharmacokinetic profile, allowing for more efficient delivery to infected tissues and organs.
Researchers can utilize PubCompare.ai's AI-powered platform to optimize protocols and identify the best products for studying liposomal amphotericin B, improving reproducibility and accuracy in their fungal infection research.
The platform's AI-driven comparisons help researchers discover optimized protocols and identify the most effective products from literature, pre-prints, and patents.
Conducting research on liposomal amphotericin B often involves the use of RPMI 1640 medium, a commonly used cell culture medium, and the Synergy H1 Hybrid Reader, a versatile microplate reader.
Researchers may also employ FACSDiva software for flow cytometry analysis and utilize compounds like tolbutamide, DMSO, and acetonitrile in their experiments.
By leveraging the insights and tools provided by PubCompare.ai, researchers can enhance the efficiency and accuracy of their liposomal amphotericin B studies, leading to better understanding and treatment of fungal infections.