{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T05:59:51Z","timestamp":1792648791038,"version":"4.5.0"},"reference-count":33,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2014,4,30]],"date-time":"2014-04-30T00:00:00Z","timestamp":1398816000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2014,7]]},"abstract":"<jats:p>Antifungal catheter lock therapy (Af<jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content>) with liposomal amphotericin B has been used in the treatment of pediatric central line infections caused by <jats:italic>Candida<\/jats:italic> species; however, reports describing the use of liposomal amphotericin B lock therapy in the adult hemodialysis patient population are lacking. Management of central line\u2013associated candidemia with systemic therapy alone is often challenging due to the propensity of <jats:italic>Candida<\/jats:italic> species to form biofilms on foreign bodies. We describe a 64\u2010year\u2010old woman who was receiving hemodialysis 3 times\/week and was hospitalized with persistent fungemia. Despite receiving intravenous micafungin, she had multiple positive blood cultures for <jats:italic>Candida albicans<\/jats:italic>, which finally cleared after 7\u00a0days. Her double\u2010lumen catheter was considered the most likely nidus of infection. Although catheter removal would have been preferred, this was not possible given her vasculopathy, history of multiple bloodstream infections, and lack of other available sites for vascular access. Catheter exchange was performed, and liposomal amphotericin B Af<jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content> was administered in combination with intravenous micafungin for a total of 6\u00a0days. During this time, the patient experienced no discernible adverse effects secondary to Af<jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content>. At discharge, Af<jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content> was discontinued, and intravenous micafungin was changed to oral fluconazole. After 6\u00a0months of treatment, the patient remained culture negative and maintained her dialysis access. To our knowledge, this is the first case report of liposomal amphotericin B catheter lock therapy used to manage a persistent <jats:italic>C. albicans<\/jats:italic> bloodstream infection in an adult receiving hemodialysis. Af<jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content> is a novel concept for treating catheter\u2010associated fungal infections. Liposomal amphotericin B was chosen based on its favorable in vitro activity against <jats:italic>Candida<\/jats:italic> species biofilms in catheter lock environments. We identified several barriers to implementing Af<jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content>, and these issues may prohibit the use of Af<jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content>. This case report illustrates the benefits and challenges of managing catheter\u2010associated fungal infections with Af<jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content>. Further study is required to examine the efficacy, safety, and feasibility of this approach.<\/jats:p>","DOI":"10.1002\/phar.1433","type":"journal-article","created":{"date-parts":[[2014,4,30]],"date-time":"2014-04-30T01:14:45Z","timestamp":1398820485000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Antifungal Catheter Lock Therapy for the Management of a Persistent <i>Candida albicans<\/i> Bloodstream Infection in an Adult Receiving Hemodialysis"],"prefix":"10.1002","volume":"34","author":[{"given":"V.","family":"Paul DiMondi","sequence":"first","affiliation":[{"name":"Department of Pharmacy Practice Campbell University College of Pharmacy and Health Sciences Buies Creek North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary L.","family":"Townsend","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice Campbell University College of Pharmacy and Health Sciences Buies Creek North Carolina"},{"name":"Department of Pharmacy Durham VA Medical Center Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Medicine Duke University School of Medicine Durham North Carolina"},{"name":"Department of Clinical Research Campbell University College of Pharmacy and Health Sciences Buies Creek North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Durkin","sequence":"additional","affiliation":[{"name":"Department of Medicine Duke University School of Medicine Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,4,30]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1086\/668770"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis021"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607188012002185"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1086\/599376"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1592\/phco.25.2.211.56947"},{"key":"e_1_2_5_7_1","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1128\/CMR.15.2.167-193.2002","article-title":"Biofilms: survival mechanisms of clinically relevant microorganisms","volume":"2","author":"Donlan RM","year":"2002","journal-title":"Clin Microbiol Rev"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00657-09"},{"key":"e_1_2_5_9_1","first-page":"866","volume-title":"Medical mycology","author":"Kwon\u2010Chung KJ","year":"1992"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1086\/599039"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00131-07"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1439-0507.2011.02076.x"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkr473"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drup.2004.09.002"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.46.6.1773-1780.2002"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2010.12.016"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.48.5.1727-1732.2004"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2008.07.030"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1086\/506452"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkp242"},{"key":"e_1_2_5_21_1","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1086\/647015","article-title":"Treatment of Hickman catheter sepsis using antibiotic lock technique","volume":"10","author":"Krzywda EA","year":"1995","journal-title":"Infect Control Hosp Epidemiol"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/21.5.1286"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-199410000-00015"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2004.08.034"},{"key":"e_1_2_5_25_1","first-page":"1947","article-title":"Should lock therapy always be avoided for central venous catheter\u2014associated fungal bloodstream infections?","volume":"11","author":"Pierluigi V","year":"2001","journal-title":"Clin Infect Dis"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkm262"},{"key":"e_1_2_5_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(91)90518-3"},{"key":"e_1_2_5_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.inf.0000172929.23419.cb"},{"key":"e_1_2_5_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0b013e318170b68b"},{"key":"e_1_2_5_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1439-0507.2010.01964.x"},{"key":"e_1_2_5_31_1","doi-asserted-by":"publisher","DOI":"10.1086\/606162"},{"key":"e_1_2_5_32_1","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1128\/AAC.42.4.762","article-title":"Amphotericin B in lipid emulsion: stability, compatibility, and in vitro antifungal activity","volume":"4","author":"Walker S","year":"1998","journal-title":"Antimicrob Agents Chemother"},{"key":"e_1_2_5_33_1","doi-asserted-by":"publisher","DOI":"10.1592\/phco.20.5.394.35063"},{"key":"e_1_2_5_34_1","first-page":"496","volume-title":"Trissel's stability of compounded formulations","author":"Trissel LA","year":"2005"}],"container-title":["Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fphar.1433","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fphar.1433","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/phar.1433","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T13:06:54Z","timestamp":1761052014000},"score":1,"resource":{"primary":{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/10.1002\/phar.1433"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,4,30]]},"references-count":33,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2014,7]]}},"alternative-id":["10.1002\/phar.1433"],"URL":"https:\/\/doi.org\/10.1002\/phar.1433","archive":["Portico"],"relation":{},"ISSN":["0277-0008","1875-9114"],"issn-type":[{"value":"0277-0008","type":"print"},{"value":"1875-9114","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,4,30]]},"assertion":[{"value":"2014-04-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}