Best practice guidelines for the management of adverse events associated with amphotericin B lipid complex.
BACKGROUND
Amphotericin B lipid complex is a widely used lipid-based formulation of amphotericin B, which has a broad spectrum of activity against a variety of fungal pathogens. It has also been shown to be significantly less nephrotoxic than conventional amphotericin B. However, infusional drug reactions, similar to those seen when using conventional amphotericin B, have been reported in a significant number of patients, so it is important that these are prevented or managed effectively, particularly in light of the changing epidemiology of systemic fungal infections.


METHODS
This article reviews effective strategies that can be used to reduce the risk of drug delivery reactions associated with amphotericin B lipid complex. Preserving renal function and managing spikes in serum creatinine levels are also discussed.


RESULTS
The aim of this paper is to provide healthcare professionals with clear guidance on the management of adverse events associated with amphotericin B lipid complex. Recommendations are based upon the published evidence and clinical experience from a number of different centres.


CONCLUSIONS
Amphotericin B lipid complex represents a valuable therapeutic option in the treatment of fungal infections but improved strategies for the management of infusion-related adverse events are required.
Craddock
Charles
C
Queen Elizabeth Hospital, Birmingham, UK. Charles.Craddock@uhb.nhs.uk
Anson
James
J
Chu
Patrick
P
Dodgson
Andrew
A
Duncan
Nick
N
Gomez
Cesar
C
Mehta
Jayesh
J
Sadullah
Shalal
S
Subudhi
Chinari
C
Yin
John-Liu
JL
D000666:Amphotericin B / Q000008:administration & dosage / Q000009:adverse effects*; D000935:Antifungal Agents / Q000008:administration & dosage / Q000009:adverse effects*; D016503:Drug Delivery Systems / Q000009:adverse effects*; D006801:Humans; D007262:Infusions, Intravenous / Q000009:adverse effects* / Q000379:methods*; D007674:Kidney Diseases / Q000139:chemically induced / Q000517:prevention & control*; D008081:Liposomes / Q000008:administration & dosage; D017410:Practice Guidelines as Topic
D000935:Antifungal Agents; D008081:Liposomes; C068538:liposomal amphotericin B; D000666:Amphotericin B