Liposomal amphotericin B treatment for neonatal fungal infections

Scarcella, A; Pasquariello, M B; Giugliano, Brunella; Vendemmia, Maria; Lucia, Andrea De

doi:10.1097/00006454-199802000-00013

Cited by 130 publications

(74 citation statements)

References 12 publications

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“…Because renal tubular cells are high in cholesterol, nephrotoxicity is an undesirable side effect of amphoB therapy. 24 Two strategies have been demonstrated to ameliorate renal toxicity, ie, incorporation into a liposomal amphotericin system [25][26][27][28][29][30] and salt loading before amphoB administration. [14][15][16][17][18][19][20][21]24,31 Although some clinical trials have demonstrated decreased amphoB-induced nephrotoxicity with the use of liposomal amphoB, other controlled clinical trials have failed to demonstrate improved outcomes or decreased mortality rates, compared with conventional amphoB.…”

Section: Discussionmentioning

confidence: 99%

Effects of Fluid and Electrolyte Management on Amphotericin B-Induced Nephrotoxicity Among Extremely Low Birth Weight Infants

et al. 2004

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ABSTRACT. Objective. Greater use of invasive procedures and aggressive antimicrobial therapy predispose extremely low birth weight (ELBW) infants to systemic fungal sepsis. Despite its adverse effects (including renal and electrolyte disturbances), amphotericin B (amphoB) remains the preferred drug for fungal therapy. Multiple studies have indicated that sodium loading may prevent renal toxicity among animals and human adults. The effects of fluid and electrolyte management on amphoBinduced nephrotoxicity among ELBW infants have not been evaluated extensively. The purpose of this study was to examine the effects of fluid and electrolyte management on amphoB-induced nephrotoxicity among ELBW infants.Design/Methods. The medical records were reviewed for all ELBW infants (birth weights of <1250 g) who developed systemic fungal sepsis, requiring amphoB therapy, between January 1992 and December 2000. Demographic, clinical, and laboratory data were collected from the medical records for each patient.Results. Fungal sepsis requiring amphoB treatment developed for 4.4% of ELBW infants (25 of 573 infants), with a gestational age of 25 ؎ 1 weeks and a birth weight of 738 ؎ 37 g, at a postnatal age of 16 ؎ 2 days. Renal compromise, as manifested by low urine output and high creatinine levels, occurred for 44% of those infants (11 of 25 infants). There was no difference between the infants who developed renal compromise (renal compromise group [RCG], n ‫؍‬ 11) and those who did not (no-renalcompromise group [NCG], n ‫؍‬ 14) with respect to birth weight, gestational age, and risk factors predisposing the infants to fungal sepsis. The RCG demonstrated a decrease in urine output by 3.4 ؎ 2 days and an increase in serum creatinine levels by 3.9 ؎ 2 days after the initiation of amphoB therapy. Infants in the RCG had a significantly higher incidence of hyponatremia, compared with infants in the NCG (7 of 11 infants vs 0 of 14 infants), with no significant difference in the incidences of hypokalemia (2 of 11 infants vs 0 of 14 infants). Infants in the RCG, compared with infants in the NCG, had significantly lower mean daily sodium intakes in the 4 days before the initiation of amphoB therapy (2.6 -2.9 mEq/kg per day vs 4.2-4.7 mEq/kg per day) and in the first 4 days of amphoB treatment (2.7-3.1 mEq/kg per day vs 4.5-5.6 mEq/kg per day). Mean daily sodium intakes were not statistically significantly different between the 2 groups between day 5 and day 10 of amphoB therapy. Infants in the RCG tended to have lower mean daily potassium intakes in the 4 days before the initiation of amphoB therapy and during the first 4 days of amphoB therapy. Subsequently, the mean daily potassium intakes remained not statistically significantly different between the groups. Mean daily fluid intakes were not different between the groups.Conclusions. Conventional amphoB combined with adequate hydration and higher sodium intakes of >4 mEq/kg per day may provide effective protection against amphoB-induced nephrotoxicity among ELBW infants. Our data conf...

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Section: Discussionmentioning

confidence: 99%

Effects of Fluid and Electrolyte Management on Amphotericin B-Induced Nephrotoxicity Among Extremely Low Birth Weight Infants

et al. 2004

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“…Los ensayos prospectivos se han hecho en base a L-amB donde la tasa de respuesta a tratamiento es comparable con anfo B-d (84 y 89%, respectivamente) 34 . Con el uso de L-amB no se describen efectos adversos significativos, salvo hipokalemia leve que se recupera pronto con el aporte de potasio [35][36][37] . Un grupo de expertos de la Sociedad Europea de Microbiología Clínica e Infectología (ESCMID) se refiere al uso de L-amB, en dosis de 2,5 a 7 mg/kg/día en RN con un adecuado perfil de seguridad 38 .…”

Section: Tratamientounclassified

Candidiasis invasoras en recién nacidos: diagnóstico, tratamiento y prevención

Izquierdo

Santolaya

2014

Rev. chil. infectol.

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“…26 Information on the use of lipid formulations of amphotericin B is derived from case reports. Scarcella et al 27 used liposomal amphotericin B in 40 preterm and four full-term infants, finding a 72% efficacy. No side effects were observed.…”

Section: Treatmentmentioning

confidence: 99%

“…The standard dosage of lipid formulations ranges from 3 to 5 mg/kg/day. 18,19,[26][27][28][29][30] The Infectious Diseases Society of America (2004) recommends that lipid formulations be considered as secondline drugs. They would be recommended in the following situations: 19 unsuccessful treatment with traditional amphotericin B; patients with history of renal insufficiency; children with significant rise in creatinine levels during treatment (above 1.5 mg/dl).…”

Section: Treatmentmentioning

confidence: 99%

Controvérsias a respeito da sepse fúngica no pré-termo extremo: profilaxia e esquemas terapêuticos

Moreira¹

2005

J. Pediatr. (Rio J.)

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Liposomal amphotericin B treatment for neonatal fungal infections

Cited by 130 publications

References 12 publications

Effects of Fluid and Electrolyte Management on Amphotericin B-Induced Nephrotoxicity Among Extremely Low Birth Weight Infants

Effects of Fluid and Electrolyte Management on Amphotericin B-Induced Nephrotoxicity Among Extremely Low Birth Weight Infants

Candidiasis invasoras en recién nacidos: diagnóstico, tratamiento y prevención

Controvérsias a respeito da sepse fúngica no pré-termo extremo: profilaxia e esquemas terapêuticos

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