Continuous infusion of amphotericin B: preliminary experience at Faculdade de Medicina da Fundação ABC

Sao Paulo Medical Journal

Roberto Palermo Uehara¹  Victor Hugo Lara De Sá¹  Érika Tae Koshimura¹  Fernanda Vilas Boas Prudente¹  Luciana Tomanik Cardozo De Mello Tucunduva¹  Marina Sahade Gonçalves¹  Eliana Sueco Tibana Samano¹  Auro Del Giglio¹ 

[1] ,Fundação ABC and Hospital Estadual Mário Covas Faculdade de Medicina Santo André São Paulo ,Brazil

关键词: Amphotericin B;    Neutropenia;    Fever;    Hematology;    Leukemia;    Anfotericina B;    Neutropenia;    Febre;    Hematologia;    Leucemia;   

DOI  :  10.1590/S1516-31802005000500004

来源: SciELO

【 摘 要 】

CONTEXT AND OBJECTIVE: Intravenous amphotericin B deoxycholate (AmB-D) infusions, usually given over 4 hours, frequently induce nephrotoxicity and undesirable infusion-related side effects such as rigors and chills. There is evidence in the literature that the use of AmB-D in the form of continuous 24-hour infusion is less toxic than the usual four-hour infusion of this drug. Our objective was to evaluate the efficacy and safety of continuous infusion of AmB-D for the treatment of persistent fever in neutropenic patients with hematological malignancies after chemotherapy. DESIGN AND SETTING: Observational retrospective analysis of our experience with continuous infusion of AmB-D, at Faculdade de Medicina da Fundação ABC and Hospital Estadual Mário Covas in Santo André. METHODS: From October 2003 to May 2004, 12 patients with hematological malignancies and chemotherapy-induced neutropenia received 13 cycles of continuous infusion of AmB-D. RESULTS: The median dose of AmB-D was 0.84 mg/kg/day (0.33 to 2.30 mg/kg/day). Concomitant use of nephrotoxic medications occurred in 92% of the cycles. Nephrotoxicity occurred in 30.76% of the cycles, hypokalemia in 16.67%, hepatotoxicity in 30% and adverse infusion-related events in 23%. All patients survived for at least seven days after starting continuous infusion of AmB-D, and clinical resolution occurred in 76% of the cycles. CONCLUSIONS: Continuous infusion of AmB-D can be used in our Institution as an alternative to the more toxic four-hour infusion of AmB-D and possibly also as an alternative to the more expensive liposomal formulations of the drug.

【 授权许可】

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