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Liposomal amphotericin B and renal safety

dc.contributor.authorMaertens, Johan
dc.contributor.authorBirne, Rita
dc.contributor.authorFelton, Timothy
dc.contributor.authorNeofytos, Dionysios
dc.contributor.authorHoenigl, Martin
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.pblBritish Society for Antimicrobial Chemotherapy | Oxford University Press
dc.date.accessioned2026-01-26T11:34:01Z
dc.date.available2026-01-26T11:34:01Z
dc.date.issued2026-01-19
dc.descriptionPublisher Copyright: © The Author(s) 2026. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy.
dc.description.abstractInvasive 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.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent1107231
dc.identifier.doi10.1093/jac/dkaf473
dc.identifier.issn0305-7453
dc.identifier.otherPURE: 151148280
dc.identifier.otherPURE UUID: 4c2ea47e-a614-4131-897e-f6c9bf067a5c
dc.identifier.otherScopus: 105027821705
dc.identifier.otherPubMed: 41549663
dc.identifier.urihttp://hdl.handle.net/10362/199708
dc.identifier.urlhttps://www.scopus.com/pages/publications/105027821705
dc.language.isoeng
dc.peerreviewedyes
dc.subjectPharmacology
dc.subjectMicrobiology (medical)
dc.subjectPharmacology (medical)
dc.subjectInfectious Diseases
dc.subjectSDG 3 - Good Health and Well-being
dc.titleLiposomal amphotericin B and renal safetyen
dc.title.subtitlereview of the evidence and clinical considerationsen
dc.typereview
degois.publication.issue2
degois.publication.titleThe Journal of antimicrobial chemotherapy
degois.publication.volume81
dspace.entity.typePublication
rcaap.rightsopenAccess

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