[Use of amphotericin B in lipid emulsions: does it prevent its toxicity in critically ill patients?].
BACKGROUND
Amphotericin B is efficacious for the treatment of systemic candidiasis, however it has potentially serious toxic effects. Administration as lipid emulsions has been advocated to decrease its toxicity.


OBJECTIVE
To compare the safety and tolerance of amphotericin B administered as lipid emulsion or dissolved in dextrose in water.


METHODS
Forty five patients with confirmed or highly suspected systemic candidiasis were studied. Between January 1996 and June 1997 amphotericin B was administered in dextrose in water to 17 patients (group 1). Between July 1997 and December 1998, the drug was delivered in lipid emulsions (Intralipid, group 2). Clinical and laboratory parameters (serum creatinine, urea nitrogen and potassium), were assessed daily.


RESULTS
Both treatment groups were clinically comparable and had the same survival. Accumulative amphotericin B dose administered was 343.2 +/- 197 and 414.6 +/- 518 mg respectively. Hypokalemia was more frequent in group 2 (52 and 25% respectively, p < 0.05). There were no differences in the outcome of renal function or other adverse reactions.


CONCLUSIONS
Administration of amphotericin B as lipid emulsions did not reduce its toxicity in critical patients (Rev Méd Chile 2000; 128: 1101-07).
Hernández
G
G
Programa de Medicina Intensiva y Departamento de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile.
Altermatt
F
F
Bernucci
F
F
Acuña
D
D
Apablaza
F
F
Valenzuela
F
F
Lefio
A
A
Pérez
C
C
Bugedo
G
G
Castillo
L
L
D018806:APACHE; D000666:Amphotericin B / Q000008:administration & dosage* / Q000009:adverse effects; D000935:Antifungal Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002177:Candidiasis / Q000188:drug therapy*; D016009:Chi-Square Distribution; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage*; D005260:Female; D005947:Glucose / Q000008:administration & dosage; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged
D000935:Antifungal Agents; D005217:Fat Emulsions, Intravenous; D000666:Amphotericin B; D005947:Glucose