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タイトル: | Comparison of the safety and cost-effectiveness of nebulized liposomal amphotericin B and amphotericin B deoxycholate for antifungal prophylaxis after lung transplantation |
著者: | Umemura, Keisuke Katada, Yoshiki Nakagawa, Shunsaku Hira, Daiki https://orcid.org/0000-0001-8344-2469 (unconfirmed) Yutaka, Yojiro Tanaka, Satona https://orcid.org/0000-0002-0789-2350 (unconfirmed) Ohsumi, Akihiro Nakajima, Daisuke Date, Hiroshi Nagao, Miki https://orcid.org/0000-0002-8886-6145 (unconfirmed) Terada, Tomohiro |
著者名の別形: | 梅村, 圭祐 片田, 佳希 中川, 俊作 平, 大樹 豊, 洋次郎 田中, 里奈 大角, 明宏 中島, 大輔 伊達, 洋至 長尾, 美紀 寺田, 智祐 |
キーワード: | Nebulized liposomal amphotericin B Nebulized amphotericin B deoxycholate Lung transplantation Fungal prophylaxis Pharmacoeconomics |
発行日: | Aug-2024 |
出版者: | Elsevier BV |
誌名: | Journal of Infection and Chemotherapy |
巻: | 30 |
号: | 8 |
開始ページ: | 741 |
終了ページ: | 745 |
抄録: | Introduction: Fungal infection after lung transplantation can lead to poor clinical outcome, for which lung transplant recipients require prophylaxis. One of the antifungal agents used after lung transplantation is nebulized amphotericin B (AMB). Nebulized AMB causes adverse events such as dyspnea and airway irritation, and long-term use leads to high economic costs. So far, prophylactic regimens employing AMB deoxycholate (AMB-d) and liposomal AMB (L-AMB) have been developed. This study compared the efficacy, safety, and cost of AMB-d and L-AMB. Patients and methods: Patients who underwent lung transplantation at Kyoto University Hospital from January 2021 to May 2023 were included in this study. Thirty-three patients received nebulized AMB-d, whereas 29 received nebulized L-AMB. Results: Both regimens maintained comparable prophylactic efficacy regarding the development of fungal infection in the AMB-d and L-AMB groups (3.0% vs. 3.4%, P = 0.877). Patients treated with nebulized L-AMB experienced fewer respiratory-related adverse reactions than those treated with nebulized AMB-d (6.9% vs. 30.3%, P < 0.05), leading to a longer treatment duration with L-AMB than with AMB-d. Additionally, the daily cost of administering L-AMB was lower than that of administering AMB-d (3609 Japanese yen vs. 1792.3 Japanese yen, P < 0.05). Discussion: These results suggest that nebulized L-AMB is safer and more cost-effective than nebulized AMB-d, with comparable efficacy. |
著作権等: | © 2024. This manuscript version is made available under the CC-BY-NC-ND 4.0 license. The full-text file will be made open to the public on 1 August 2025 in accordance with publisher's 'Terms and Conditions for Self-Archiving'. This is not the published version. Please cite only the published version. この論文は出版社版でありません。引用の際には出版社版をご確認ご利用ください。 |
URI: | http://hdl.handle.net/2433/287857 |
DOI(出版社版): | 10.1016/j.jiac.2024.02.010 |
PubMed ID: | 38354908 |
出現コレクション: | 学術雑誌掲載論文等 |
このアイテムは次のライセンスが設定されています: クリエイティブ・コモンズ・ライセンス