Comparison of effects of amphotericin B deoxycholate infused over 4 or 24 hours: randomised controlled trial.
OBJECTIVE
To test the hypothesis that amphotericin B deoxycholate is less toxic when given by continuous infusion than by conventional rapid infusion.


METHODS
Randomised, controlled, non-blinded, single centre study.


METHODS
University hospital providing tertiary clinical care.


METHODS
80 mostly neutropenic patients with refractory fever and suspected or proved invasive fungal infections.


METHODS
Patients were randomised to receive 0.97 mg/kg amphotericin B by continuous infusion over 24 hours or 0.95 mg/kg by rapid infusion over four hours.


METHODS
Patients were evaluated for side effects related to infusion, nephrotoxicity, and mortality up to three months after treatment. Analysis was on an intention to treat basis.


RESULTS
Patients in the continuous infusion group had fewer side effects and significantly reduced nephrotoxicity than those in the rapid infusion group. Overall mortality was higher during treatment and after three months' follow up in the rapid infusion than in the continuous infusion group.


CONCLUSIONS
Continuous infusions of amphotericin B reduce nephrotoxicity and side effects related to infusion without increasing mortality.
Medicine B, University Hospital, University of Zurich, CH-8091 Zurich, Switzerland. klinerr@usz.unizh.ch
U
U
Eriksson
B
B
Seifert
A
A
Schaffner
D000293:Adolescent; D000328:Adult; D000368:Aged; D000666:Amphotericin B / Q000008:administration & dosage* / Q000009:adverse effects; D000935:Antifungal Agents / Q000008:administration & dosage* / Q000009:adverse effects; D003840:Deoxycholic Acid / Q000008:administration & dosage* / Q000009:adverse effects; D004334:Drug Administration Schedule; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000150:complications / Q000188:drug therapy*; D009503:Neutropenia / Q000150:complications; D009894:Opportunistic Infections / Q000150:complications / Q000188:drug therapy*; D011446:Prospective Studies; D015996:Survival Rate
D000935:Antifungal Agents; D004338:Drug Combinations; D003840:Deoxycholic Acid; D000666:Amphotericin B; C059765:amphotericin B, deoxycholate drug combination