Clinical efficacy of amphotericin B colloidal dispersion against infections caused by Aspergillus spp.
Three published clinical trials of the efficacy of amphotericin B colloidal dispersion (ABCD) against infections caused by Aspergillus spp were reviewed. A total of 376 patients was treated. Systemic aspergillosis was identified in 67 evaluable patients. Overall, a complete or partial response was achieved in 47.8% of the evaluable patients, although there were substantial differences in the response rates between studies. Reasons for recruitment caused a marked difference in response rates. The overall response rate for ABCD in patients in which conventional amphotericin B (CAB) was contra-indicated or had previously failed was 34.3%, whereas the response rate in bone marrow transplant (BMT) or patients with renal impairment was 57.9 and 62.5% respectively. The efficacy of ABCD at doses of 4 mg/kg/day appears to be at least as good as in studies using CAB. The levels of renal toxicity were low at a dose of 4 mg/kg/day. Dose-limiting studies indicate that dosages can be safely increased to 7.5 mg/kg/day creating opportunity for improved efficacy.
Gurwith
M
M
ALZA Corporation, Menlo Park, CA 94025, USA.
D000666:Amphotericin B / Q000008:administration & dosage* / Q000009:adverse effects; D000935:Antifungal Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001228:Aspergillosis / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D016469:Fungemia / Q000188:drug therapy*; D006801:Humans; D016896:Treatment Outcome
D000935:Antifungal Agents; D000666:Amphotericin B