Reduced renal toxicity and improved clinical tolerance of amphotericin B mixed with intralipid compared with conventional amphotericin B in neutropenic patients.
The clinical use of amphotericin B is sometimes limited by nephrotoxicity. In a randomized prospective study, 32 patients treated for haematological malignancies received either amphotericin B in 5% dextrose (group A, 16 patients, 0.7-1 mg/kg/day), or amphotericin B mixed with Intralipid (group B, 16 patients, 0.7-1 mg/kg/day) during prolonged neutropenia. Renal dysfunction occurred in 9/16 patients in group A and 2/16 patients in group B (P < 0.05). Clinical tolerance was improved with a reduction of fever with chills in 12/16 patients in group A compared with 5/16 in group B (P < 0.05). Preparation of amphotericin B with Intralipid reduces nephrotoxicity, improves clinical tolerance, may allow an increase in the daily dose of amphotericin B, and be an alternative to liposomal-amphotericin B infusion.
Moreau
P
P
Department of Haematology, CHU Hôtel Dieu, Nantes, France.
Milpied
N
N
Fayette
N
N
Ramée
J F
JF
Harousseau
J L
JL
D000328:Adult; D000368:Aged; D000666:Amphotericin B / Q000008:administration & dosage* / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D004359:Drug Therapy, Combination; D004361:Drug Tolerance; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007668:Kidney / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000188:drug therapy; D009503:Neutropenia / Q000150:complications*
D005217:Fat Emulsions, Intravenous; D000666:Amphotericin B; D003404:Creatinine