Clearance of fungal burden during treatment of disseminated histoplasmosis with liposomal amphotericin B versus itraconazole

L. J. Wheat, G. Cloud, P. C. Johnson, P. Connolly, M. Goldman, A. Le Monte, D. E. Fuller, T. E. Davis, R. Hafner

Research output: Contribution to journalArticle

63 Scopus citations

Abstract

Animal studies have shown that fungal burden correlates with survival during treatment with new antifungal therapies for histoplasmosis. The purpose of this report is to compare the clearance of fungal burden in patients with histoplasmosis treated with liposomal amphotericin B versus itraconazole. In two separate closed clinical trials that evaluated the efficacy of liposomal amphotericin B and itraconazole treatment of disseminated histoplasmosis in patients with AIDS, blood was cultured for fungus and blood and urine were tested for Histoplasma antigen. The clinical response rates were similar; 86% with liposomal amphotericin B (n = 51) versus 85% with itraconazole (n = 59). Of the patients with positive blood cultures at enrollment, after 2 weeks of therapy cultures were negative in over 85% of the liposomal amphotericin B group versus 53% of the itraconazole group (P = 0.0008). Furthermore, after 2 weeks, median antigen levels in serum fell by 1.6 U in the liposomal amphotericin B group versus 0.1 U in the itraconazole group (P = 0.02), and those in urine fell by 2.1 U in the liposomal amphotericin B group and 0.2 U in the itraconazole group (P = 0.0005). The more rapid clearance of fungemia supports the use of liposomal amphotericin B rather than itraconazole for initial treatment of moderately severe or severe histoplasmosis.

Original languageEnglish (US)
Pages (from-to)2354-2357
Number of pages4
JournalAntimicrobial Agents and Chemotherapy
Volume45
Issue number8
DOIs
StatePublished - Jul 31 2001

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

Fingerprint Dive into the research topics of 'Clearance of fungal burden during treatment of disseminated histoplasmosis with liposomal amphotericin B versus itraconazole'. Together they form a unique fingerprint.

  • Cite this