Experience of research nurses with oral encochleated amphotericin B for treatment of cryptococcal meningitis in a resource-limited setting
Abstract Background Besides the commonly used intravenous formulations of amphotericin B, an oral nanocrystal amphotericin B (MAT2203) formulation is being evaluated for efficacy to treat invasive fungal infections. This new experimental oral formulation has not been used before. Methods Herein, we...
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2025-07-01
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| Online Access: | https://doi.org/10.1186/s12879-025-11319-1 |
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| author | Cynthia Ahimbisibwe Richard Kwizera Jane Frances Ndyetukira Olivie Carolyne Namujju Alisat Sadiq Mucunguzi Atukunda Caleb P. Skipper David R. Boulware David B. Meya |
| author_facet | Cynthia Ahimbisibwe Richard Kwizera Jane Frances Ndyetukira Olivie Carolyne Namujju Alisat Sadiq Mucunguzi Atukunda Caleb P. Skipper David R. Boulware David B. Meya |
| author_sort | Cynthia Ahimbisibwe |
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| description | Abstract Background Besides the commonly used intravenous formulations of amphotericin B, an oral nanocrystal amphotericin B (MAT2203) formulation is being evaluated for efficacy to treat invasive fungal infections. This new experimental oral formulation has not been used before. Methods Herein, we describe our experiences with using oral amphotericin B for management of patients with HIV-associated cryptococcal meningitis in Uganda from a research nurse perspective. Results We found oral amphotericin B a better alternative to intravenous amphotericin B deoxycholate due to less toxicity, mostly limited to gastrointestinal-related toxicities only. We clinically observed no drug reactions like rigors, phlebitis, and less vomiting among patients on oral amphotericin B as compared to those on intravenous amphotericin B deoxycholate. Subjectively, meningitis symptoms of patients on oral amphotericin B seemed to overall clinically improve more rapidly compared to those receiving intravenous amphotericin B deoxycholate. Few adverse events were observed. A novel challenge with oral amphotericin was difficulty in monitoring adherence for the night doses in the absence of the healthcare providers. Conclusions Oral amphotericin B was generally safe and well tolerated. However, it requires some training for the nurse, patient and care takers for better administration, adherence and treatment outcomes. Trial registration This was observational sub-study that was nested under the EnACT trial. The EnACT trial was registered prospectively. ClincalTrials.gov: NCT04031833; Registration date: July 24, 2019; Last verified: March 31, 2023. |
| format | Article |
| id | doaj-art-b81d4a43d87543739c1fa2de3a8cc1b3 |
| institution | Kabale University |
| issn | 1471-2334 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj-art-b81d4a43d87543739c1fa2de3a8cc1b32025-08-20T03:45:47ZengBMCBMC Infectious Diseases1471-23342025-07-012511410.1186/s12879-025-11319-1Experience of research nurses with oral encochleated amphotericin B for treatment of cryptococcal meningitis in a resource-limited settingCynthia Ahimbisibwe0Richard Kwizera1Jane Frances Ndyetukira2Olivie Carolyne Namujju3Alisat Sadiq4Mucunguzi Atukunda5Caleb P. Skipper6David R. Boulware7David B. Meya8Infectious Diseases Institute, College of Health Sciences, Makerere UniversityInfectious Diseases Institute, College of Health Sciences, Makerere UniversityInfectious Diseases Institute, College of Health Sciences, Makerere UniversityInfectious Diseases Institute, College of Health Sciences, Makerere UniversityInfectious Diseases Institute, College of Health Sciences, Makerere UniversityInfectious Diseases Institute, College of Health Sciences, Makerere UniversityDepartment of Medicine, Division of Infectious Diseases and International Medicine, University of MinnesotaDepartment of Medicine, Division of Infectious Diseases and International Medicine, University of MinnesotaInfectious Diseases Institute, College of Health Sciences, Makerere UniversityAbstract Background Besides the commonly used intravenous formulations of amphotericin B, an oral nanocrystal amphotericin B (MAT2203) formulation is being evaluated for efficacy to treat invasive fungal infections. This new experimental oral formulation has not been used before. Methods Herein, we describe our experiences with using oral amphotericin B for management of patients with HIV-associated cryptococcal meningitis in Uganda from a research nurse perspective. Results We found oral amphotericin B a better alternative to intravenous amphotericin B deoxycholate due to less toxicity, mostly limited to gastrointestinal-related toxicities only. We clinically observed no drug reactions like rigors, phlebitis, and less vomiting among patients on oral amphotericin B as compared to those on intravenous amphotericin B deoxycholate. Subjectively, meningitis symptoms of patients on oral amphotericin B seemed to overall clinically improve more rapidly compared to those receiving intravenous amphotericin B deoxycholate. Few adverse events were observed. A novel challenge with oral amphotericin was difficulty in monitoring adherence for the night doses in the absence of the healthcare providers. Conclusions Oral amphotericin B was generally safe and well tolerated. However, it requires some training for the nurse, patient and care takers for better administration, adherence and treatment outcomes. Trial registration This was observational sub-study that was nested under the EnACT trial. The EnACT trial was registered prospectively. ClincalTrials.gov: NCT04031833; Registration date: July 24, 2019; Last verified: March 31, 2023.https://doi.org/10.1186/s12879-025-11319-1Amphotericin BCryptococcal meningitisResearch nurseClinical researchUganda |
| spellingShingle | Cynthia Ahimbisibwe Richard Kwizera Jane Frances Ndyetukira Olivie Carolyne Namujju Alisat Sadiq Mucunguzi Atukunda Caleb P. Skipper David R. Boulware David B. Meya Experience of research nurses with oral encochleated amphotericin B for treatment of cryptococcal meningitis in a resource-limited setting BMC Infectious Diseases Amphotericin B Cryptococcal meningitis Research nurse Clinical research Uganda |
| title | Experience of research nurses with oral encochleated amphotericin B for treatment of cryptococcal meningitis in a resource-limited setting |
| title_full | Experience of research nurses with oral encochleated amphotericin B for treatment of cryptococcal meningitis in a resource-limited setting |
| title_fullStr | Experience of research nurses with oral encochleated amphotericin B for treatment of cryptococcal meningitis in a resource-limited setting |
| title_full_unstemmed | Experience of research nurses with oral encochleated amphotericin B for treatment of cryptococcal meningitis in a resource-limited setting |
| title_short | Experience of research nurses with oral encochleated amphotericin B for treatment of cryptococcal meningitis in a resource-limited setting |
| title_sort | experience of research nurses with oral encochleated amphotericin b for treatment of cryptococcal meningitis in a resource limited setting |
| topic | Amphotericin B Cryptococcal meningitis Research nurse Clinical research Uganda |
| url | https://doi.org/10.1186/s12879-025-11319-1 |
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