Document Detail


Amphotericin B in neonates: deoxycholate or lipid formulation as first-line therapy - is there a 'right' choice?
MedLine Citation:
PMID:  21301335     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Anna Turkova; Emmanuel Roilides; Mike Sharland
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in infectious diseases     Volume:  24     ISSN:  1473-6527     ISO Abbreviation:  Curr. Opin. Infect. Dis.     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-02-24     Completed Date:  2011-04-06     Revised Date:  2012-01-31    
Medline Journal Info:
Nlm Unique ID:  8809878     Medline TA:  Curr Opin Infect Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  163-71     Citation Subset:  IM    
Affiliation:
Paediatric Infectious Diseases Unit, St George's Hospital, London, UK.
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MeSH Terms
Descriptor/Qualifier:
Amphotericin B / 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:
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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