| Amphotericin B in neonates: deoxycholate or lipid formulation as first-line therapy - is there a 'right' choice? | |
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MedLine Citation:
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PMID: 21301335 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE OF REVIEW: The aim is to compare the available evidence on the efficacy and safety of deoxycholate and lipid amphotericin B formulations (AMBF) in the treatment of invasive fungal disease (IFD) in neonates. The review also aims to summarize current practices and recommendations. RECENT FINDINGS: To date most AMBF studies on neonates consist of retrospective reports and case series. The reviewed reports show that both amphotericin B deoxycholate (DAMB) and lipid formulations appear to have equal efficacy in treating IFD in neonates. The adverse effects of DAMB in neonates are considerably less than those in older children and adults. There is a trend of more nephrotoxicity reported with DAMB than with lipid formulations; however, the range reported is very wide (0-70%). Neonates with normal baseline renal function appeared to tolerate DAMB relatively well. A sodium intake of 4 mEq/kg/day may significantly reduce DAMB nephrotoxicity. SUMMARY: Deoxycholate amphotericin B is inexpensive and effective in treating neonatal IFD. It appears to be safe for use as first-line therapy if the underlying risk for nephrotoxicity is low and renal function and potassium are monitored closely. |
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Authors:
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Anna Turkova; Emmanuel Roilides; Mike Sharland |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Current opinion in infectious diseases Volume: 24 ISSN: 1473-6527 ISO Abbreviation: Curr. Opin. Infect. Dis. Publication Date: 2011 Apr |
Date Detail:
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Created Date: 2011-02-24 Completed Date: 2011-04-06 Revised Date: 2012-01-31 |
Medline Journal Info:
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Nlm Unique ID: 8809878 Medline TA: Curr Opin Infect Dis Country: United States |
Other Details:
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Languages: eng Pagination: 163-71 Citation Subset: IM |
Affiliation:
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Paediatric Infectious Diseases Unit, St George's Hospital, London, UK. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Amphotericin B
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administration & dosage,
therapeutic use* Antifungal Agents / administration & dosage, therapeutic use* Deoxycholic Acid / administration & dosage, therapeutic use Drug Combinations Humans Infant, Newborn Infusions, Intravenous Mycoses / drug therapy*, prevention & control Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Antifungal Agents; 0/Drug Combinations; 0/liposomal amphotericin B; 1397-89-3/Amphotericin B; 83-44-3/Deoxycholic Acid; 87687-70-5/amphotericin B, deoxycholate drug combination |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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