Pharmacokinetics of liposomal amphotericin B in pleural fluid.
We report the penetration of liposomal amphotericin B into the pleural fluid of a patient with pulmonary zygomycosis and empyema. The ratio of area under the concentration-versus-time curve in pleural fluid (AUC(pleural fluid)) to that in serum (AUC(serum)) for liposomal amphotericin B over 24 h was 9.4%, with pleural fluid concentrations of 2.12 to 4.91 microg/ml. Given the relatively low level of intrapleural penetration of liposomal amphotericin B, chest tube drainage may be warranted for successful treatment of zygomycotic empyema.
Moriyama
Brad
B
NIH Clinical Center Pharmacy Department, 10 Center Drive, Bethesda, MD 20892, USA. bmoriyama@cc.nih.gov
Torabi-Parizi
Parizad
P
Pratt
Alexandra K
AK
Henning
Stacey A
SA
Pennick
Gennethel
G
Shea
Yvonne R
YR
Roy Chowdhuri
Sinchita
S
Rinaldi
Michael G
MG
Barrett
A John
AJ
Walsh
Thomas J
TJ
D000666:Amphotericin B / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics*; D000935:Antifungal Agents / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics*; D016724:Empyema, Pleural / Q000188:drug therapy / Q000378:metabolism; D005260:Female; D006801:Humans; D008081:Liposomes; D008172:Lung Diseases, Fungal / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism*; D008875:Middle Aged; D009091:Mucormycosis / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism*; D010996:Pleural Effusion / Q000188:drug therapy / Q000378:metabolism*
D000935:Antifungal Agents; D008081:Liposomes; C068538:liposomal amphotericin B; D000666:Amphotericin B