What is it about?

Invasive fungal infections, caused for example by Candida, Aspergillus or Mucorales, are life-threatening, especially in patients with blood cancers or in intensive care. Liposomal amphotericin B is one of the most important drugs against them and also treats visceral leishmaniasis, a parasitic disease. Clinical trials, however, do not always reflect everyday practice. In the AMPHO-SITA study we reviewed 389 adults treated with this drug in 14 Italian hospitals between 2020 and 2024. Four in ten had a haematological malignancy and half were in intensive care. The drug was started on suspicion of infection in about half of cases and as targeted therapy in the other half. Mortality among patients with fungal infections was high (36% at 30 days, 61% at 90 days), and heart failure severity and organ dysfunction (SOFA score) predicted death.

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Why is it important?

This is one of the largest real-world studies on liposomal amphotericin B. It shows that the drug remains essential across very different and severely ill patient groups, with a manageable safety profile, and that outcomes depend heavily on the patient's underlying condition. These data help clinicians and stewardship teams understand where this valuable antifungal is used, identify patients at highest risk, and plan future studies.

Perspectives

Invasive fungal infections are often recognized late and carry a heavy burden of mortality. Being part of this large Italian network allowed us to look beyond clinical trials and see how amphotericin B is really used at the bedside. Collaborative real-world studies like AMPHO-SITA are crucial to improve antifungal stewardship.

Professor Stefano Di Bella
Universita degli Studi di Trieste

Read the Original

This page is a summary of: Real-world use of liposomal amphotericin B: A large retrospective, observational, multicentre study, International Journal of Antimicrobial Agents, December 2026, Elsevier,
DOI: 10.1016/j.ijantimicag.2026.107952.
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