Application and evaluation of topical amphotericin B for the treatment of respiratory fungal infections

BMC Infect Dis. 2024 Apr 24;24(1):439. doi: 10.1186/s12879-024-09342-9.

Abstract

Background: In recent years, the prevalence of respiratory fungal diseases has increased. Polyene antifungal drugs play a pivotal role in the treatment of these conditions, with amphotericin B (AmB) being the most representative drug. This study aimed to evaluate the efficacy and safety of topical administration of AmB in the treatment of respiratory fungal infections.

Methods: We conducted a retrospective study on hospitalized patients treated with topical administered AmB for respiratory fungal infections from January 2014 to June 2023.

Results: Data from 36 patients with invasive pulmonary fungal infections treated with topical administration of AmB were collected and analyzed. Nebulization was administered to 27 patients. After the treatment, 17 patients evidenced improved conditions, whereas 10 patients did not respond and died in the hospital. One patient experienced an irritating cough as an adverse reaction. Seven patients underwent tracheoscopic instillation, and two received intrapleural irrigation; they achieved good clinical therapeutic efficacy without adverse effects.

Conclusion: The combined application of systemic antifungal treatment and topical administration of AmB yielded good therapeutic efficacy and was well-tolerated by the patients. Close monitoring of routine blood tests, liver and kidney function, and levels of electrolytes, troponin, and B-type natriuretic peptide supported this conclusion.

Keywords: Amphotericin B; Fungal infection; Topical administration.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Topical*
  • Adult
  • Aged
  • Aged, 80 and over
  • Amphotericin B* / administration & dosage
  • Amphotericin B* / adverse effects
  • Amphotericin B* / therapeutic use
  • Antifungal Agents* / administration & dosage
  • Antifungal Agents* / adverse effects
  • Antifungal Agents* / therapeutic use
  • Female
  • Humans
  • Lung Diseases, Fungal / drug therapy
  • Male
  • Middle Aged
  • Respiratory Tract Infections / drug therapy
  • Respiratory Tract Infections / microbiology
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult

Substances

  • Amphotericin B
  • Antifungal Agents