title: Peritoneal penetration of amphotericin B lipid complex and fluconazole in a pediatric patient with fungal peritonitis.
abstract: Fungal peritonitis is a rare event in patients receiving peritoneal dialysis. This case report describes the blood and dialysate concentrations of fluconazole and amphotericin B following intravenous administration in a 5-month-old infant with Candida albicans peritonitis receiving continuous cyclic peritoneal dialysis. Fluconazole rapidly and efficiently penetrated the peritoneal fluid achieving concentrations that exceed the minimal inhibitory concentration (MIC) for most Candida species. In contrast, the amount of amphotericin B in the dialysate was below the limit of quantification despite measurable blood concentrations. This suggests that fluconazole represents a better choice for antifungal therapy because of its excellent peritoneal penetration.
authors.affiliation: Department of Pediatrics, University of Missouri-Kansas City, USA.
authors.forename: D L
authors.initials: DL
authors.lastname: Blowey
authors.forename: U C
authors.initials: UC
authors.lastname: Garg
authors.forename: G L
authors.initials: GL
authors.lastname: Kearns
authors.forename: B A
authors.initials: BA
authors.lastname: Warady
mesh_terms: D000666:Amphotericin B / Q000008:administration & dosage / Q000493:pharmacokinetics*; D000935:Antifungal Agents / Q000008:administration & dosage / Q000493:pharmacokinetics*; D001202:Ascitic Fluid / Q000737:chemistry*; D002177:Candidiasis / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D015725:Fluconazole / Q000008:administration & dosage / Q000493:pharmacokinetics*; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous; D008297:Male; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010538:Peritonitis / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D010713:Phosphatidylcholines / Q000008:administration & dosage / Q000493:pharmacokinetics*; D010715:Phosphatidylglycerols / Q000008:administration & dosage / Q000493:pharmacokinetics*
chemical_list: D000935:Antifungal Agents; D004338:Drug Combinations; D010713:Phosphatidylcholines; D010715:Phosphatidylglycerols; C068538:liposomal amphotericin B; D000666:Amphotericin B; D015725:Fluconazole