Successful use of amphotericin B lipid complex in the treatment of cryptococcosis

The efficacy and renal safety of amphotericin B lipid complex ( ABLC) injection were assessed in 106 patients with cryptococcal infection. Eighty- three patients ( 78%) had a central nervous system ( CNS) infection. Of these patients, 20 initiated azole therapy concomitantly with ABLC therapy, and 7 had received prior azole therapy, which continued during administration of ABLC. Clinical response ( cured or improved) was achieved in 67 ( 66%) of 101 patients whose results could be evaluated. Response rates were 65% ( 51/ 78) for patients with a CNS infection and 70% ( 16/ 23) for patients without a CNS infection. The response rate for patients with HIV infection was 58% ( 30/ 52). Response rates were 56% ( 19/ 34) for patients who were refractory to prior antifungal therapy, 65% ( 11/ 17) for patients who were intolerant of prior antifungal therapy, 60% ( 3/ 5) for patients with underlying renal disease who received prior antifungal therapy, 76% ( 25/ 33) for patients with underlying renal disease who did not receive prior antifungal therapy, and 73% ( 8/ 11) for patients with no renal disease who did not receive prior antifungal therapy. A mean serum creatinine level decrease of 0.02 mg/ dL occurred. ABLC was an effective treatment for cryptococcal infection in immunocompromised patients.