Comparative pharmacodynamics of amphotericin B lipid complex and liposomal amphotericin B in a murine model of pulmonary mucormycosis

Antimicrob Agents Chemother. 2010 Mar;54(3):1298-304. doi: 10.1128/AAC.01222-09. Epub 2009 Dec 28.

Abstract

We compared the kinetics of amphotericin B (AMB) lung accumulation and fungal clearance by liposomal amphotericin B (L-AMB) and amphotericin B lipid complex (ABLC) in a neutropenic murine model of invasive pulmonary mucormycosis (IPM). Immunosuppressed BALB/c mice were inoculated with 1 x 10(6) Rhizopus oryzae spores and administered L-AMB or ABLC at daily intravenous doses of 1, 5, or 10 mg/kg of body weight for 5 days starting 12 h after infection. At a dose of 10 mg/kg/day, both L-AMB and ABLC were effective at reducing the R. oryzae lung fungal burden and achieved lung tissue concentrations exceeding the isolate mean fungicidal concentration (MFC) of 8 microg/ml by 72 h. When ABLC was dosed at 5 mg/kg/day, the ABLC-treated animals had significantly higher AMB lung concentrations than the L-AMB treated animals at 24 h (6.64 and 1.44 microg/g, respectively; P = 0.013) and 72 h (7.49 and 1.03 microg/g, respectively; P = 0.005), and these higher concentrations were associated with improved fungal clearance, as determined by quantitative real-time PCR (mean conidial equivalent of R. oryzae DNA per lung, 4.44 +/- 0.44 and 6.57 +/- 0.74 log(10), respectively; P < 0.001). Analysis of the AMB tissue concentration-response relationships revealed that the suppression of R. oryzae growth in the lung required tissue concentrations that approached the MFC for the infecting isolate (50% effective concentration, 8.19 microg/g [95% confidence interval, 2.81 to 18.1 microg/g]). The rates of survival were similar in the animals treated with L-AMB and ABLC at 10 mg/kg/day. These data suggest that higher initial doses may be required during L-AMB treatment than during ABLC treatment of experimental IPM.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amphotericin B / administration & dosage
  • Amphotericin B / pharmacology
  • Amphotericin B / therapeutic use*
  • Animals
  • Antifungal Agents / administration & dosage
  • Antifungal Agents / pharmacology
  • Antifungal Agents / therapeutic use*
  • Disease Models, Animal*
  • Humans
  • Lung / microbiology
  • Lung Diseases, Fungal / drug therapy*
  • Lung Diseases, Fungal / microbiology
  • Mice
  • Mice, Inbred BALB C
  • Microbial Sensitivity Tests
  • Mucormycosis / drug therapy*
  • Mucormycosis / microbiology
  • Mucormycosis / mortality
  • Rhizopus / drug effects*
  • Treatment Outcome

Substances

  • Antifungal Agents
  • liposomal amphotericin B
  • Amphotericin B