Real-World Outcomes of Amphotericin B Colloidal Dispersion as Salvage Therapy for Invasive Fungal Disease

Purpose: The incidence of invasive fungal disease (IFD) has significantly increased in recent years, partly driven by the expanding immunocompromised population, as well as severe influenza and COVID-19. Amphotericin B (AmB) is highly effective against a broad spectrum of fungal infections and has a low drug resistance rate, but its clinical use is limited by toxicity. Amphotericin B colloidal dispersion (ABCD), a lipid formulation of AmB, is preferred in China for its reduced toxicity. This study assesses real-world clinical outcomes of ABCD as salvage therapy in IFD patients who failed prior treatment with triazoles or echinocandins. Methods: We conducted a single-center, retrospective study of IFD patients who received ABCD salvage therapy between September 2021 and February 2024. Clinical data were systematically reviewed to assess the clinical outcomes of ABCD. Results: Among the 60 patients included, the clinical response rate to ABCD was 71.7% (43/60; 95% confidence interval [CI], 59.2-81.5%). Outcomes did not vary significantly with factors such as gender, underlying conditions, infection sites, or prior antifungal treatments. Incidence rates of hepatotoxicity, nephrotoxicity, and infusion-related reactions were 13.3%, 23.3%, and 1.7%, respectively. Five patients discontinued ABCD due to adverse events. Conclusion: In this real-world setting, ABCD salvage therapy was associated with favorable clinical outcomes and an acceptable safety profile in IFD patients who failed prior azole or echinocandin therapy.