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Comparison of effects of amphotericin B deoxycholate infused over 4 or 24 hours: randomised controlled trial

BMJ 2001; 322 doi: https://doi.org/10.1136/bmj.322.7286.579 (Published 10 March 2001) Cite this as: BMJ 2001;322:579
  1. Urs Eriksson, physiciana (klinerr{at}usz.unizh.ch),
  2. Burkhard Seifert, statisticianb,
  3. Andreas Schaffner, professora
  1. a Medicine B, University Hospital, University of Zurich, CH-8091 Zurich, Switzerland
  2. b Department of Biostatistics, University of Zurich
  1. Correspondence to: U Eriksson, Medicine A, University Hospital, CH-4031 Basel, Switzerland on
  • Accepted 4 December 2000

Abstract

Objective: To test the hypothesis that amphotericin B deoxycholate is less toxic when given by continuous infusion than by conventional rapid infusion.

Design: Randomised, controlled, non-blinded, single centre study.

Setting: University hospital providing tertiary clinical care.

Patients: 80 mostly neutropenic patients with refractory fever and suspected or proved invasive fungal infections.

Intervention: Patients were randomised to receive 0.97 mg/kg amphotericin B by continuous infusion over 24 hours or 0.95 mg/kg by rapid infusion over four hours.

Main outcome measures: Patients were evaluated for side effects related to infusion, nephrotoxicity, and mortality up to three months after treatment. Analysis was on an intention to treat basis.

Results: Patients in the continuous infusion group had fewer side effects and significantly reduced nephrotoxicity than those in the rapid infusion group. Overall mortality was higher during treatment and after three months' follow up in the rapid infusion than in the continuous infusion group.

Conclusion: Continuous infusions of amphotericin B reduce nephrotoxicity and side effects related to infusion without increasing mortality

Footnotes

  • Funding None.

  • Competing interests UE has been reimbursed by Bristol-Myers Squibb, the manufacturer of amphotericin B deoxycholate (Fungizone), for attending the 39th interscience conference on antimicrobial agents and chemotherapy, 1999, San Francisco, California.

  • Accepted 4 December 2000
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