ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2009
Lipid formulations of amphotericin B significantly improve outcome in solid organ transplant recipients with central nervous system cryptococcosis.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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19 citing papers in PubMed, 1 synthesis or guideline pooled it, 61 citations in OpenAlex.
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- The incidences and clinical outcomes of cryptococcosis in Taiwan: A nationwide, population-based study, 2002-2015.Medical mycology · 2024Article
- Combination Therapy for HIV-Associated Cryptococcal Meningitis-A Success Story.Journal of fungi (Basel, Switzerland) · 2021Review
- Central Nervous System Cryptococcal Infections in Non-HIV Infected Patients.Journal of fungi (Basel, Switzerland) · 2019Review
- Disseminated Cryptococcosis in a Patient with Multiple Myeloma Treated with Daratumumab, Lenalidomide, and Dexamethasone.Internal medicine (Tokyo, Japan) · 2019Article
- EQUALOpen forum infectious diseases · 2018Review
- Outcomes of cryptococcosis in renal transplant recipients in a less-resourced health care system.Transplant infectious disease : an official journal of the Transplantation Society · 2018Article
- Review
- Epidemiological characterization and prognostic factors in patients with confirmed cerebral cryptococcosis in central Taiwan.The journal of venomous animals and toxins including tropical diseases · 2015Article
- Antifungal pharmacokinetics and pharmacodynamics.Cold Spring Harbor perspectives in medicine · 2014Review
- Pharmacodynamics of liposomal amphotericin B and flucytosine for cryptococcal meningoencephalitis: safe and effective regimens for immunocompromised patients.The Journal of infectious diseases · 2013Article
- Outcomes associated with conventional versus lipid-based formulations of amphotericin B in propensity-matched groups.ClinicoEconomics and outcomes research : CEOR · 2013Article
- Predictors of mortality and differences in clinical features among patients with Cryptococcosis according to immune status.PloS one · 2013Article
- Article
- The efficacy of voriconazole in the treatment of 192 fungal central nervous system infections: a retrospective analysis.Infection · 2011Article
- Recent advances in management of cryptococcal meningitis: commentary.F1000 medicine reports · 2010Article
- Identifying predictors of central nervous system disease in solid organ transplant recipients with cryptococcosis.Transplantation · 2010Article
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31 authors at 20 institutions in 6 countries.
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Abstract
backgroundWhether outcome of central nervous system (CNS) cryptococcosis in solid organ transplant recipients treated with lipid formulations of amphotericin B is different from the outcome of the condition treated with amphotericin B deoxycholate (AmBd) is not known.
methodsWe performed a multicenter study involving a cohort comprising consecutive solid organ transplant recipients with CNS cryptococcosis.
resultsOf 75 patients treated with polyenes as induction regimens, 55 (73.3%) received lipid formulations of amphotericin B and 20 (26.7%) received AmBd. Similar proportions of patients in both groups had renal failure at baseline (P = .94 ). Overall, mortality at 90 days was 10.9% in the group that received lipid formulations of amphotericin B and 40.0% in the group that received AmBd. In univariate analysis, nonreceipt of calcineurin inhibitors (P = .034), renal failure at baseline (P = .016), and fungemia (P = .003) were significantly associated with mortality. Compared with AmBd, lipid formulations of amphotericin B were associated with a lower mortality (P = .007). Mortality did not differ between patients receiving lipid formulations of amphotericin B with or without flucytosine (P = .349). In stepwise logistic regression analysis, renal failure at baseline (odds ratio [OR], 4.61; 95% confidence interval [CI], 1.02-20.80; P = .047) and fungemia (OR, 10.66; 95% CI, 2.08-54.55; P = .004 ) were associated with an increased mortality, whereas lipid formulations of amphotericin B were associated with a lower mortality (OR, 0.11; 95% CI, 0.02-0.57; P = .008).
conclusionsLipid formulations of amphotericin B were independently associated with better outcome and may be considered as the first-line treatment for CNS cryptococcosis in these patients.
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