Efficacy of liposomal amphotericin B in treating fungal meningitis in AIDS Patients: A review article … Original Research Article … |
The Egyptian Journal of Immunology E-ISSN (2090-2506) Volume 32 (1), January 2025 Pages: 27–41. www.Ejimmunology.org https://doi.org/10.55133/eji.320103 |
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Sariya Khan1, Husna I. Thalib1, Ayesha Jamal1, Zainab M. A. Takroni1, Mohammed A. Alfaqih2, and Manal El Said3,4 |
1General Medicine Practice Program, Batterjee Medical College, Jeddah 21442, Saudi Arabia.
2Department of Medicine & Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia. 3Department of Microbiology and Infection Prevention & Control Unit, Theodor Bilharz Research Institute, Giza 12411, Egypt. 4General Medicine Practice Program, Department of Microbiology, Batterjee Medical College, Jeddah 21442, Saudi Arabia.
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Corresponding author: Sariya Khan, General Medicine Practice Program, Batterjee Medical College, Jeddah 21442, Saudi Arabia. Email: khansariya22@gmail.com. |
Abstract
Cryptococcal meningitis is an alarming fungal infection that usually affects the meninges surrounding the brain and spinal cord. The causative organism is Cryptococcus neoformans. Although this infection can occur in normal individuals, it is more often seen in patients with human immunodeficiency virus/acquired immunodeficiency syndrome. Amphotericin B is an antifungal medication often used to treat severe fungal infections. It belongs to the class of polyene antifungal drugs, and it acts by binding to the cell membrane of the fungus. This causes some essential cellular components to leak out and ultimately the fungus dies. However, the administration of Amphotericin B is associated with toxicity. Therefore, lipid formulations are preferred to decrease the toxicity and increase the therapeutic index of the drug. It is widely used since it has a longer tissue half-life, the drug induced toxic effects are lower and it can penetrate the brain tissue efficaciously. This review collects and analyzes several research studies and literature reviews found in the electronic databases. The inclusion criteria prioritize studies focusing on the efficacy and drawbacks of using liposomal Amphotericin B as a treatment for fungal meningitis. In conclusion, liposomal Amphotericin B showed more effective treatment compared to other available antifungal drugs. Patients treated with a single dose of liposomal Amphotericin B coupled with fluconazole and flucytosine exhibited fewer adverse events and the mortality rate was also lower as compared to the control group.
Keywords:
Cryptococcal Meningitis, Fungal Meningitis, Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome, Amphotericin B, Liposomal Amphotericin B, Antifungal Drugs
Date received:
26 June 2024; accepted: 12 October 2024
PMID:
39803853
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