Efficacy, safety, and economy of amphotericin B liposome versus cholesterol sulfate in the treatment of invasive fungal infections: a retrospective cohort study

Background Amphotericin B is mainly used to treat invasive fungal infections (IFIs). Comparative studies of amphotericin B liposome versus cholesterol sulfate for IFIs are limited. Objectives This study aims to compare the efficacy, safety, and economy between amphotericin B liposome and cholesterol sulfate in the treatment of IFIs. Methods 308 patients with IFIs were included and divided into amphotericin B liposome group (n = 110) and amphotericin B cholesterol sulfate group (n = 198). The effectiveness, safety and economy were retrospectively compared. The influencing factors were evaluated through univariate and multivariate logistic regression. Results There was no significant difference in efficacy between the two groups. The incidence of infusion reactions in the cholesterol sulfate group was significantly higher than that in the liposome group. The hypoproteinemia and bloodstream infection were independently associated with 42-day in-hospital mortality. The bloodstream infection, combined diuretics and combined non-steroidal anti-inflammatory drugs were independently associated with renal dysfunction. The hypoalbuminemia and urinary system infection were independently associated with hypokalemia. Although amphotericin B cholesterol sulfate have a lower drug cost, there is no significant difference in the total hospitalization cost between two groups. Conclusion No statistically significant difference was found between two groups, which is insufficient to support the equivalent efficacy or safety of two treatments. The infusion reactions safety of amphotericin B liposome is superior to amphotericin B cholesterol sulfate. The hypoproteinemia and bloodstream infections are associated with poor prognosis. The bloodstream infection and combined diuretics are positively correlated with renal dysfunction, while combined non-steroidal anti-inflammatory drugs is negatively correlated. The hypoalbuminemia and urinary system infection are closely associated with hypokalemia.