{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T20:50:04Z","timestamp":1789419004637,"version":"build-2803163510"},"reference-count":45,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2020,12,21]],"date-time":"2020-12-21T00:00:00Z","timestamp":1608508800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100016016","name":"Gilead UK and Ireland Corporate Contributions","doi-asserted-by":"publisher","award":["07512"],"award-info":[{"award-number":["07512"]}],"id":[{"id":"10.13039\/100016016","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoF"],"abstract":"<jats:p>Triazoles remain first-line agents for antifungal prophylaxis in high-risk haemato-oncology patients, but their use is increasingly contraindicated due to drug\u2013drug interactions and additive toxicities with novel treatments. In this retrospective, single-centre, observational study, we present our eight-year experience of antifungal prophylaxis using intermittent high-dose liposomal Amphotericin B (L-AmB). All adults identified through our Antifungal Stewardship Programme as receiving L-AmB prophylaxis at 7.5 mg\/kg once-weekly between February 2012 and January 2020 were included. Adverse reactions, including infusion reactions, electrolyte loss, and nephrotoxicity, were recorded. \u2018Breakthrough\u2019 invasive fungal infection (IFI) occurring within four weeks of L-AmB was classified using European Organization for Research and Treatment of Cancer\/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC\/MSG) criteria. Moreover, 114 courses of intermittent high-dose L-AmB prophylaxis administered to 92 unique patients were analysed. Hypokalaemia was the most common grade 3\u20134 adverse event, with 26 (23%) courses. Grade 3 nephrotoxicity occurred in 8 (7%) and reversed in all six patients surviving to 90 days. There were two (1.8%) episodes of breakthrough IFI, one \u2018probable\u2019 and one \u2018possible\u2019. In this study, the largest evaluation of intermittent high-dose L-AmB prophylaxis conducted to date, toxicity was manageable and reversible and breakthrough IFI was rare. L-AmB prophylaxis represents a viable alternative for patients with a contraindication to triazoles.<\/jats:p>","DOI":"10.3390\/jof6040385","type":"journal-article","created":{"date-parts":[[2020,12,21]],"date-time":"2020-12-21T20:42:01Z","timestamp":1608583321000},"page":"385","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Safety and Efficacy of Intermittent High-Dose Liposomal Amphotericin B Antifungal Prophylaxis in Haemato-Oncology: An Eight-Year Single-Centre Experience and Review of the Literature"],"prefix":"10.3390","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8781-2615","authenticated-orcid":false,"given":"Jonathan","family":"Youngs","sequence":"first","affiliation":[{"name":"Institute of Infection &amp; Immunity, St George\u2019s University of London, Cranmer Terrace, Tooting, London SW17 0RE, UK"},{"name":"Department of Infection, St George\u2019s University Hospitals NHS Foundation Trust, Blackshaw Rd, Tooting, London SW17 0QT, UK"},{"name":"Clinical Academic Group in Infection and Immunity, St George\u2019s University of London, Cranmer Terrace, London SW17 0RE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6689-0320","authenticated-orcid":false,"given":"Jen Mae","family":"Low","sequence":"additional","affiliation":[{"name":"St George\u2019s University Hospitals NHS Foundation Trust, Blackshaw Rd, Tooting, London SW17 0QT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Whitney","sequence":"additional","affiliation":[{"name":"Pharmacy Department, St George\u2019s University Hospitals NHS Foundation Trust, Blackshaw Rd, Tooting, London SW17 0QT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare","family":"Logan","sequence":"additional","affiliation":[{"name":"Institute of Infection &amp; Immunity, St George\u2019s University of London, Cranmer Terrace, Tooting, London SW17 0RE, UK"},{"name":"Department of Infection, St George\u2019s University Hospitals NHS Foundation Trust, Blackshaw Rd, Tooting, London SW17 0QT, UK"},{"name":"Clinical Academic Group in Infection and Immunity, St George\u2019s University of London, Cranmer Terrace, London SW17 0RE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janice","family":"Chase","sequence":"additional","affiliation":[{"name":"Pharmacy Department, St George\u2019s University Hospitals NHS Foundation Trust, Blackshaw Rd, Tooting, London SW17 0QT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0558-0772","authenticated-orcid":false,"given":"Ting","family":"Yau","sequence":"additional","affiliation":[{"name":"Pharmacy Department, St George\u2019s University Hospitals NHS Foundation Trust, Blackshaw Rd, Tooting, London SW17 0QT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Klammer","sequence":"additional","affiliation":[{"name":"Department of Haematology, St George\u2019s University Hospitals NHS Foundation Trust, Blackshaw Rd, Tooting, London SW17 0QT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4368-2502","authenticated-orcid":false,"given":"Mickey","family":"Koh","sequence":"additional","affiliation":[{"name":"Clinical Academic Group in Infection and Immunity, St George\u2019s University of London, Cranmer Terrace, London SW17 0RE, UK"},{"name":"Department of Haematology, St George\u2019s University Hospitals NHS Foundation Trust, Blackshaw Rd, Tooting, London SW17 0QT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tihana","family":"Bicanic","sequence":"additional","affiliation":[{"name":"Institute of Infection &amp; Immunity, St George\u2019s University of London, Cranmer Terrace, Tooting, London SW17 0RE, UK"},{"name":"Department of Infection, St George\u2019s University Hospitals NHS Foundation Trust, Blackshaw Rd, Tooting, London SW17 0QT, UK"},{"name":"Clinical Academic Group in Infection and Immunity, St George\u2019s University of London, Cranmer Terrace, London SW17 0RE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,12,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3043","DOI":"10.1200\/JCO.18.00374","article-title":"Antimicrobial Prophylaxis for Adult Patients with Cancer-Related Immunosuppression: ASCO and IDSA Clinical Practice Guideline Update","volume":"36","author":"Taplitz","year":"2018","journal-title":"J. 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