Publication: Aerosolized liposomal Amphotericin B: A potential prophylaxis of invasive pulmonary aspergillosis in immunocompromised patients
Issued Date
2014-01-01
Resource Type
ISSN
10990496
87556863
87556863
Other identifier(s)
2-s2.0-84900010976
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Mahidol University
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SCOPUS
Bibliographic Citation
Pediatric Pulmonology. Vol.49, No.6 (2014), 574-580
Suggested Citation
Harutai Kamalaporn, Kitty Leung, Mark Nagel, Saranya Kittanakom, Battista Calvieri, Reinhart A F Reithmeier, Allan L. Coates Aerosolized liposomal Amphotericin B: A potential prophylaxis of invasive pulmonary aspergillosis in immunocompromised patients. Pediatric Pulmonology. Vol.49, No.6 (2014), 574-580. doi:10.1002/ppul.22856 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/34777
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Title
Aerosolized liposomal Amphotericin B: A potential prophylaxis of invasive pulmonary aspergillosis in immunocompromised patients
Abstract
Background Aerosolized liposomal Amphotericin B may reduce the incidence of invasive pulmonary Aspergillosis in adults with chemotherapy-induced prolonged neutropenia with less nephrotoxicity. The breath-actuated AeroEclipse® BAN nebulizer is very efficient and minimizes environmental drug contamination since no aerosol is produced, unless the patient is inspiring through the device. Our aim is to develop an appropriate delivery system suitable for children that does not disrupt the liposomes due to the shear forces in nebulization. Methods This is an in vitro experimental study in vitro. Six ml of 4 mg/ml liposomal Amphotericin B solution (AmBisome®; Astellas Pharma Inc., Markham, Ontario, CA) was nebulized with the breath-actuated nebulizer (AeroEclipse®; Trudell Medical International, Canada) and captured by the glass liquid impinger. Sodium dodecyl sulfate was used as detergent to disrupt the liposomes in control samples. Gel filtration, electron microscopy, and high performance liquid chromatography (HPLC) were used to compare the size and shape of the liposomes, and amount of the drug before and after nebulization. The aerosol particle size was obtained by the laser diffraction. Results After nebulization, 97.5% of amphotericin B was captured by the liquid impinger and detected by HPLC. Gel filtration and electron microscopy demonstrated that the drug remained in its liposomal configuration after nebulization. The mass median diameter (MMD) was 3.7 μm and 66% of aerosol particles were less than 5 μm in diameter. Conclusions We demonstrated that liposomal Amphotericin B can be nebulized successfully without disrupting the liposomes and minimize drug loss by using the breath-actuated nebulizer. © 2013 Wiley Periodicals, Inc.