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Clinical evaluation of a new lipid-based delivery system for intravenous administration of amphotericin B

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Abstract

In a retrospective study a new lipid-based delivery system for administration of amphotericin B was evaluated in 26 treatment courses in 22 patients. Amphotericin B was given by infusion diluted in either the lipid solution (1 mg/kg/d; 13 courses) or dextrose (0.92 mg/kg/d; 13 courses). No differences were noted in the serum pharmacokinetics. Fever or rigors were observed in 6 of 13 courses in the conventional amphotericin B group versus none in the lipid amphotericin B group (p=0.007). Four of 13 courses of treatment were discontinued due to adverse effects in the conventional amphotericin B group compared to none in the other group (p=0.048). In the lipid amphotericin B group the decrease in creatinine clearance was significantly lower on the fourth day of treatment (p=0.04) and significantly fewer patients had a decrease of more than 25 % in creatinine clearance on the sixth day (4/12 vs 9/11 p=0.02). These preliminary findings suggest that this lipid amphotericin B formulation is well tolerated with few nephrotoxic effects.

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References

  1. Gallis HA, Drew RH, Pickard WW Amphotericin B: 30 years of clinical experience. Reviews of Infectious Diseases 1990, 11: 308–329.

    Google Scholar 

  2. Pirsch JD, Maki DG Infectious complications in adults with bone marrow transplantation and T-cell depletion of donor marrow. Increased susceptibility to fungal infection. Annals of Internal Medicine 1986, 104: 619–631.

    PubMed  Google Scholar 

  3. Butler WT, Bennett JE, Alling DW, Wertlake PT, Utz JP, Hill GJ Nephrotoxicity of amphotericin B: early and late effects in 81 patients. Annals of internal Medicine 1964, 61: 175–187.

    PubMed  Google Scholar 

  4. Kucers A, Mck Bennett N Amphotericin B (AMB). In: Heinemann W (ed): The use of antibiotics. A comprehensive review with clinical emphasis. Heinemann, London, 1987, p. 1441–1477.

    Google Scholar 

  5. Brajtburg J, Powderly WG, Kobayashi GS, Medoff G Amphotericin B: delivery systems. Antimicrobial Agents and Chemotherapy 1990, 34: 381–384.

    PubMed  Google Scholar 

  6. Lopez-Berestein G, Fainstein V, Hopfer R, Mehta K, Sullivan MP, Keating M, Rosenblum MG, Mehta R, Luna M, Hersh EM, Reuben J, Juliano RL, Bodey GP Liposomal amphotericin B for the treatment of systemic fungal infections in patients with cancer: a preliminary study. Journal of Infectious Diseases 1985, 151: 704–710.

    PubMed  Google Scholar 

  7. Tollemar J, Ringden O, Tyden G Liposomal amphotericin B (Ambisome) treatment in solid organ and bone marrow transplant recipients. Efficacy and safety evaluation. Clinical Transplantation 1990, 4: 167–715.

    Google Scholar 

  8. Wiebe VJ, DeGregorio MW Liposome-encapsulated amphotericin B: a promising new treatment for disseminated fungal infections. Reviews of Infectious Diseases 1988, 10: 1097–1101.

    PubMed  Google Scholar 

  9. Kirsh R, Goldstein R, Tarloff J, Parris D, Hook J, Hanna N, Bugelski P, Poste G An emulsion formulation of amphotericin B improves the therapeutic index when treating systemic murine candidiasis. Journal of Infectious Diseases 1988, 158: 1065–1070.

    PubMed  Google Scholar 

  10. Gigliotti F, Shenep JL, Lott L, Thornton D Induction of prostaglandin synthesis as the mechanism responsible for chills and fever produced by infusing amphotericin B. Journal of Infectious Diseases 1987, 156: 784–789.

    PubMed  Google Scholar 

  11. Chia JKS, McManus EJ In vitro tumor necrosis factor induction assay for analysis of febrile toxicity associated with amphotericin B preparations. Antimicrobial Agents and Chemotherapy 1990, 34: 906–908.

    PubMed  Google Scholar 

  12. Brajtburg J, Elberg S, Kobayashi GS, Medoff G Inhibition of amphotericin B (amphotericin B) toxicity to cells by egg lecithin-glycoholic acid mixed micelles. Antimicrobial Agents and Chemotherapy 1990, 34: 2415–2416.

    PubMed  Google Scholar 

  13. Hopfer RL, Mills K, Mehta R, Lopez-Berestein G, Fainstein V, Juliano RL In vitro antifungal activities of amphotericin B and liposomes encapsulated amphotericin B. Antimicrobial Agents and Chemotherapy 1984, 25: 387–389.

    PubMed  Google Scholar 

  14. Ralph ED, Khazindar AM, Barber KR, Grant CWM Comparative in vitro effects of liposomal amphotericin B, amphotericin B-deoxycholate, and free amphotericin B against fungal strains determined by using MIC and minimal lethal concentration susceptibility studies and time-kill curves. Antimicrobial Agents and Chemotherapy 1991, 35: 188–191.

    PubMed  Google Scholar 

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Caillot, D., Chavanet, P., Casasnovas, O. et al. Clinical evaluation of a new lipid-based delivery system for intravenous administration of amphotericin B. Eur. J. Clin. Microbiol. Infect. Dis. 11, 722–725 (1992). https://doi.org/10.1007/BF01989977

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