Tratamiento de infecciones fúngicas sistémicas. III parte: Anfotericina B, aspectos farmacoeconómicos y decisiones terapéuticas

This third part contains a review on amphotericin B, pharmacoeconomical aspects and clinical decision involved during therapy selection of antifungal agents. Amphotericin B, the standard of antifungal therapy is associated with significant infusion adverse events and nephrotoxicity but has the wides...

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Autor principal:	Fica C,Alberto
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Chilena de Infectología 2004
Materias:	anfotericina B deoxicolato Formulaciones de anfotericina B asociadas a lípidos Infecciones fúngicas Tratamiento
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0716-10182004000400006
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spelling	oai:scielo:S0716-101820040004000062005-04-14Tratamiento de infecciones fúngicas sistémicas. III parte: Anfotericina B, aspectos farmacoeconómicos y decisiones terapéuticasFica C,Alberto anfotericina B deoxicolato Formulaciones de anfotericina B asociadas a lípidos Infecciones fúngicas Tratamiento This third part contains a review on amphotericin B, pharmacoeconomical aspects and clinical decision involved during therapy selection of antifungal agents. Amphotericin B, the standard of antifungal therapy is associated with significant infusion adverse events and nephrotoxicity but has the widest spectrum of activity against fungal species involved in human infections. It is a recognized first line-therapy in high-risk patients with criptocococcal meningitis, invasive aspergillosis, mucormicosis, and as an empirical therapy in persistently febrile neutropenic patients without renal failure. Several lipid associated formulations of amphotericin B are available that provide lesser nephrotoxicity but at a considerable higher cost and an adverse cost-effectiveness ratio. Several small-randomized controlled trials of IntralipidÒ formulations of amphotericin B have been published but controversy remains. Few pharmacoeconomical analysis have been published and mostly refer to lipid associated formulations of amphotericin B versus the conventional form. As stated, potential economical benefits obtained with lipid associated formulations of amphotericin B by avoiding more cases of renal failure are surpassed by their enormous acquisition costs. On the other hand, amphotericin B is a cost-effective alternative compared to a prolonged iv fluconazol therapy but not when switching to oral therapy is scheduled before the first week. Intravenous itraconazole (not available in Chile) is reportedly more cost-effective than conventional amphotericin B for the treatment of persistently febrile neutropenic patients.info:eu-repo/semantics/openAccessSociedad Chilena de InfectologíaRevista chilena de infectología v.21 n.4 20042004-12-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0716-10182004000400006es10.4067/S0716-10182004000400006
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	anfotericina B deoxicolato Formulaciones de anfotericina B asociadas a lípidos Infecciones fúngicas Tratamiento
spellingShingle	anfotericina B deoxicolato Formulaciones de anfotericina B asociadas a lípidos Infecciones fúngicas Tratamiento Fica C,Alberto Tratamiento de infecciones fúngicas sistémicas. III parte: Anfotericina B, aspectos farmacoeconómicos y decisiones terapéuticas
description	This third part contains a review on amphotericin B, pharmacoeconomical aspects and clinical decision involved during therapy selection of antifungal agents. Amphotericin B, the standard of antifungal therapy is associated with significant infusion adverse events and nephrotoxicity but has the widest spectrum of activity against fungal species involved in human infections. It is a recognized first line-therapy in high-risk patients with criptocococcal meningitis, invasive aspergillosis, mucormicosis, and as an empirical therapy in persistently febrile neutropenic patients without renal failure. Several lipid associated formulations of amphotericin B are available that provide lesser nephrotoxicity but at a considerable higher cost and an adverse cost-effectiveness ratio. Several small-randomized controlled trials of IntralipidÒ formulations of amphotericin B have been published but controversy remains. Few pharmacoeconomical analysis have been published and mostly refer to lipid associated formulations of amphotericin B versus the conventional form. As stated, potential economical benefits obtained with lipid associated formulations of amphotericin B by avoiding more cases of renal failure are surpassed by their enormous acquisition costs. On the other hand, amphotericin B is a cost-effective alternative compared to a prolonged iv fluconazol therapy but not when switching to oral therapy is scheduled before the first week. Intravenous itraconazole (not available in Chile) is reportedly more cost-effective than conventional amphotericin B for the treatment of persistently febrile neutropenic patients.
author	Fica C,Alberto
author_facet	Fica C,Alberto
author_sort	Fica C,Alberto
title	Tratamiento de infecciones fúngicas sistémicas. III parte: Anfotericina B, aspectos farmacoeconómicos y decisiones terapéuticas
title_short	Tratamiento de infecciones fúngicas sistémicas. III parte: Anfotericina B, aspectos farmacoeconómicos y decisiones terapéuticas
title_full	Tratamiento de infecciones fúngicas sistémicas. III parte: Anfotericina B, aspectos farmacoeconómicos y decisiones terapéuticas
title_fullStr	Tratamiento de infecciones fúngicas sistémicas. III parte: Anfotericina B, aspectos farmacoeconómicos y decisiones terapéuticas
title_full_unstemmed	Tratamiento de infecciones fúngicas sistémicas. III parte: Anfotericina B, aspectos farmacoeconómicos y decisiones terapéuticas
title_sort	tratamiento de infecciones fúngicas sistémicas. iii parte: anfotericina b, aspectos farmacoeconómicos y decisiones terapéuticas
publisher	Sociedad Chilena de Infectología
publishDate	2004
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0716-10182004000400006
work_keys_str_mv	AT ficacalberto tratamientodeinfeccionesfungicassistemicasiiiparteanfotericinabaspectosfarmacoeconomicosydecisionesterapeuticas
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Tratamiento de infecciones fúngicas sistémicas. III parte: Anfotericina B, aspectos farmacoeconómicos y decisiones terapéuticas

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