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Volume 13
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10.3390/antibiotics13111015
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Article

Patterns of Amphotericin B Use and Factors Related to Mortality in a Low-Middle Income Country: An Observational and Longitudinal Study

by
Luis Fernando Valladales-Restrepo
1,2,3,
Lian Manuela Soto-Romero
3,
Luis Fernando Navarrete-Santa
3,
Rodrigo Montoya-García
3,
Jaime Andrés Ríos-Montoya
3,
Alejandra Sabogal-Ortiz
4 and
Jorge Enrique Machado-Alba
1,*
1
Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A., Pereira 660003, Colombia
2
Grupo de Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira 660001, Colombia
3
Semillero de Investigación en Farmacología Geriátrica, Grupo de Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira 660001, Colombia
4
Grupo Operador Clínico, Área de Salud, Cali 760045, Colombia
*
Author to whom correspondence should be addressed.
Antibiotics 2024, 13(11), 1015; https://doi.org/10.3390/antibiotics13111015
Submission received: 30 August 2024 / Revised: 23 October 2024 / Accepted: 25 October 2024 / Published: 29 October 2024
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Abstract

Background/Objectives: Amphotericin B is indicated in deep systemic fungal infections. The aim was to determine the sociodemographic, clinical and pharmacological variables of a group of Colombian patients treated with amphotericin B and factors associated with mo rtality. Methods: A longitudinal observational retrospective study on the use of amphotericin B in Colombia was conducted between January 2015 and December 2022. The multivariate analysis sought to identify variables related to mortality. Results: A total of 310 patients were identified, with a median age of 44.0 years, and 71.0% were women. Conventional amphotericin B was the most used (74.8%). The main uses were cryptococcosis (38.7%), histoplasmosis (31.9%) and candidiasis (29.4%). More than a third of patients died during hospitalization (40.3%). An increase in the Charlson Comorbidity Index score (HR: 1.13; 95% CI: 1.05–1.22) and in the qSOFA score (HR: 1.34; 95% CI: 1.04–1.73), coinfection by Mycobacterium tuberculosis (HR: 2.09; 95% CI: 1.32–3.31) and the requirement of vasopressors (HR: 4.20; 95% CI: 2.16–8.15) or invasive mechanical ventilation (HR: 2.73; 95% CI: 1.40–5.33) increased the probability of in-hospital death. In contrast, those who received systemic corticosteroids (HR: 0.43; 95% CI: 0.26–0.70) had a lower risk. Conventional amphotericin B is the most used drug mainly treating Cryptococcus neoformans infections. Conclusions: The use of amphotericin B was consistent with clinical practice guideline recommendations. In-hospital mortality was common, and factors such as increased comorbidities, higher qSOFA scores, coinfection with Mycobacterium tuberculosis and invasive procedures like mechanical ventilation were linked to increased mortality.
Keywords: amphotericin B; antifungal agents; mortality; mycoses; pharmacoepidemiology; Colombia amphotericin B; antifungal agents; mortality; mycoses; pharmacoepidemiology; Colombia

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MDPI and ACS Style

Valladales-Restrepo, L.F.; Soto-Romero, L.M.; Navarrete-Santa, L.F.; Montoya-García, R.; Ríos-Montoya, J.A.; Sabogal-Ortiz, A.; Machado-Alba, J.E. Patterns of Amphotericin B Use and Factors Related to Mortality in a Low-Middle Income Country: An Observational and Longitudinal Study. Antibiotics 2024, 13, 1015. https://doi.org/10.3390/antibiotics13111015

AMA Style

Valladales-Restrepo LF, Soto-Romero LM, Navarrete-Santa LF, Montoya-García R, Ríos-Montoya JA, Sabogal-Ortiz A, Machado-Alba JE. Patterns of Amphotericin B Use and Factors Related to Mortality in a Low-Middle Income Country: An Observational and Longitudinal Study. Antibiotics. 2024; 13(11):1015. https://doi.org/10.3390/antibiotics13111015

Chicago/Turabian Style

Valladales-Restrepo, Luis Fernando, Lian Manuela Soto-Romero, Luis Fernando Navarrete-Santa, Rodrigo Montoya-García, Jaime Andrés Ríos-Montoya, Alejandra Sabogal-Ortiz, and Jorge Enrique Machado-Alba. 2024. "Patterns of Amphotericin B Use and Factors Related to Mortality in a Low-Middle Income Country: An Observational and Longitudinal Study" Antibiotics 13, no. 11: 1015. https://doi.org/10.3390/antibiotics13111015

APA Style

Valladales-Restrepo, L. F., Soto-Romero, L. M., Navarrete-Santa, L. F., Montoya-García, R., Ríos-Montoya, J. A., Sabogal-Ortiz, A., & Machado-Alba, J. E. (2024). Patterns of Amphotericin B Use and Factors Related to Mortality in a Low-Middle Income Country: An Observational and Longitudinal Study. Antibiotics, 13(11), 1015. https://doi.org/10.3390/antibiotics13111015

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