Medizinische Universität Graz - Research portal
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SHR Neuro Cancer Cardio Lipid Metab Microb
Maertens, J; Birne, R; Felton, T; Neofytos, D; Hoenigl, M.
Liposomal amphotericin B and renal safety: review of the evidence and clinical considerations.
J Antimicrob Chemother. 2026; 81(2):
Doi: 10.1093/jac/dkaf473
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- Co-authors Med Uni Graz
- Hönigl Martin
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- Abstract:
- Invasive fungal infections continue to represent an important cause of morbidity and mortality in severely ill and immunocompromised patients. Liposomal amphotericin B (LAmB) has a significantly improved toxicity profile versus conventional amphotericin B deoxycholate and is recommended for a wide range of medically important opportunistic fungal pathogens. Although rates are significantly lower than with older formulations, nephrotoxicity with LAmB remains a concern. Risk factors for renal toxicity with LAmB include higher doses, longer duration of treatment, concomitant use of nephrotoxic agents and the presence of pre-existing kidney disease. Appropriate patient screening, individualized risk assessment, and patient monitoring may reduce the risk of renal toxicity. The prophylactic use of intravenous saline fluids is also recommended with LAmB to reduce the risk of nephrotoxicity. In addition, magnesium and potassium supplementation should be considered to reduce the risk of hypomagnesaemia and hypokalaemia, respectively. Alternate dosing strategies, including intermittent dosing and, for certain fungal infections, single-dose high-dose induction therapy, may be useful in minimizing nephrotoxicity, but additional research is necessary.
- Find related publications in this database (using NLM MeSH Indexing)
- Humans - administration & dosage
- Amphotericin B - adverse effects, administration & dosage
- Antifungal Agents - adverse effects, administration & dosage
- Invasive Fungal Infections - drug therapy
- Kidney Diseases - chemically induced, prevention & control
- Kidney - drug effects
- Risk Factors - administration & dosage