title: Continuous infusion of amphotericin B: preliminary experience at Faculdade de Medicina da Fundação ABC.
abstract: OBJECTIVE
  Intravenous amphotericin B deoxycholate (AmB-D) infusions, usually given over 4 hours, frequently induce nephrotoxicity and undesirable infusion-related side effects such as rigors and chills. There is evidence in the literature that the use of AmB-D in the form of continuous 24-hour infusion is less toxic than the usual four-hour infusion of this drug. Our objective was to evaluate the efficacy and safety of continuous infusion of AmB-D for the treatment of persistent fever in neutropenic patients with hematological malignancies after chemotherapy.
  
  
  METHODS
  Observational retrospective analysis of our experience with continuous infusion of AmB-D, at Faculdade de Medicina da Fundação ABC and Hospital Estadual Mário Covas in Santo André.
  
  
  METHODS
  From October 2003 to May 2004, 12 patients with hematological malignancies and chemotherapy-induced neutropenia received 13 cycles of continuous infusion of AmB-D.
  
  
  RESULTS
  The median dose of AmB-D was 0.84 mg/kg/day (0.33 to 2.30 mg/kg/day). Concomitant use of nephrotoxic medications occurred in 92% of the cycles. Nephrotoxicity occurred in 30.76% of the cycles, hypokalemia in 16.67%, hepatotoxicity in 30% and adverse infusion-related events in 23%. All patients survived for at least seven days after starting continuous infusion of AmB-D, and clinical resolution occurred in 76% of the cycles.
  
  
  CONCLUSIONS
  Continuous infusion of AmB-D can be used in our Institution as an alternative to the more toxic four-hour infusion of AmB-D and possibly also as an alternative to the more expensive liposomal formulations of the drug.
authors.affiliation: Faculdade de Medicina, Fundação ABC, Hospital Estadual Mário Covas, Santo André, São Paulo, Brazil.
authors.forename: Roberto Palermo
authors.initials: RP
authors.lastname: Uehara
authors.forename: Victor Hugo Lara de
authors.initials: VH
authors.lastname: Sá
authors.forename: Erika Tae
authors.initials: ET
authors.lastname: Koshimura
authors.forename: Fernanda Vilas Boas
authors.initials: FV
authors.lastname: Prudente
authors.forename: Luciana Tomanik Cardozo de Mello
authors.initials: LT
authors.lastname: Tucunduva
authors.forename: Marina Sahade
authors.initials: MS
authors.lastname: Gonçalves
authors.forename: Eliana Sueco Tibana
authors.initials: ES
authors.lastname: Samano
authors.forename: Auro
authors.initials: A
authors.lastname: del Giglio
mesh_terms: 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; D004338:Drug Combinations; D005260:Female; D019337:Hematologic Neoplasms / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000188:drug therapy* / Q000209:etiology; D009503:Neutropenia / Q000150:complications* / Q000188:drug therapy; D009894:Opportunistic Infections / Q000188:drug therapy* / Q000209:etiology; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D004338:Drug Combinations; D003840:Deoxycholic Acid; D000666:Amphotericin B; C059765:amphotericin B, deoxycholate drug combination