Continuous infusion of amphotericin B deoxycholate: an innovative, low-cost strategy in antifungal treatment.
The combination of amphotericin B and sodium deoxycholate is the formulation most used in clinical practice. The development of new agents such as amphotericin with lipid formulations, caspofungin, voriconazole and other azolic derivatives, promoted alternatives to amphotericin B deoxycholate. However, because of the high cost of these new drugs, their use is difficult in a scenario of limited resources. A few strategies have been devised to make the use of amphotericin B deoxycholate less toxic. In this review, we seek to describe the accumulated knowledge about this molecule, with focus on its use in continuous infusion, which appears to be an alternative to reduce toxicity, while maintaining its clinical efficacy.
Falci
Diego R
DR
Infectious Diseases Unit, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
dos Santos
Rodrigo P
RP
Wirth
Fernanda
F
Goldani
Luciano Z
LZ
D000666:Amphotericin B / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics / Q000493:pharmacokinetics; D000935:Antifungal Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics / Q000493:pharmacokinetics; D002986:Clinical Trials as Topic; D003365:Costs and Cost Analysis; D003840:Deoxycholic Acid / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics / Q000493:pharmacokinetics; D004359:Drug Therapy, Combination / Q000191:economics*; D006801:Humans
D000935:Antifungal Agents; D003840:Deoxycholic Acid; D000666:Amphotericin B