How to Suitablely Manage the Mucormycosis---Recommended Dose of
Liposomal Amphotericin B and Other Management of Risk Factors?
Abstract
Mucormycosis was an acute and invasive fungal infection with a high
mortality rate. The treatment of mucormycosis was challenging. And the
incidence of the mucormycosis seems to be increasing. The key to
Mucormycosis therapy not only depend on anti-Mucor infection, but also
included the management of some risk factors. Liposomal amphotericin B
(L-AMB) was the first line drug to treat mucormycosis. The dosage
regimen recommended by the guideline was often associated with higher
nephrotoxicity and morbidity. A pharmacokinetic/pharmacodynamic (PKPD)
model was conducted to evaluate suitable dosage regimens in Mucormycosis
patients. 10mg/kg/day LAMB recommended in the guidelines might not be
needed. 5mg/kg/day LAMB might be sufficient to achieve the target value
of PKPD and indicated a good anti-Mucor effect. Successful management of
mucormycosis was also based on suitable management of several risk
factors which played a very important role in the progression of
mucormycosis, such as iron factor, diabetes mellitus with acidosis and
thrombosis. Application of deferasirox, statins and keep platelet level
might be promising approaches in mucormycosis therapy.