Document Detail

Improving outcome of treatment of kala-azar by supplementation of amphotericin B with physiologic saline and potassium chloride.
MedLine Citation:
PMID:  21036834     Owner:  NLM     Status:  MEDLINE    
Complications of amphotericin B limit its wide application in the treatment of patients with kala-azar. This study was undertaken with an aim to minimize anti-renal complications and severe rigor in course of treatment with this drug. Parasitologically confirmed kala-azar cases (n = 230) were randomized equally into two groups: a control group received amphotericin B only at a dose of 1 mg/kg of body weight/day for 20 days and a patient (test) group received 500 mL of physiologic saline and 30 mL (60 meq/L) of KC1 with amphotericin B. We observed a significantly lower increase in serum creatinine levels (P = 0.0001) and a lower incidence of severe rigor and fever (P = 0.0165) in the test group than in the control group. However, the ultimate cure rate was not significantly different (P = 0.5637) between two groups after 12 months of follow-up. Relapses occurred after even after six months in both groups. Persons with relapses were treated with 25 infusions of amphotericin B and cured. Supplementation of amphotericin B with 500 mL of physiologic saline and 30 mL (60 meq/L) of KCl during treatment could help prevent an increase in serum creatinine levels and severe rigor and would make the treatment of kala-azar with amphotericin B easier.
Chandeshwar P Thakur; A Kumar; Dipendra K Mitra; Ambak Roy; Arun Kumar Sinha; Alok Ranjan
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of tropical medicine and hygiene     Volume:  83     ISSN:  1476-1645     ISO Abbreviation:  Am. J. Trop. Med. Hyg.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-01     Completed Date:  2010-11-30     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  0370507     Medline TA:  Am J Trop Med Hyg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1040-3     Citation Subset:  AIM; IM    
Balaji Utthan Sansthan, Patna, India.
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MeSH Terms
Amphotericin B / adverse effects,  therapeutic use*
Antiprotozoal Agents / adverse effects,  therapeutic use*
Chills / chemically induced,  drug therapy
Creatinine / blood
Electrolytes / therapeutic use
Fever / chemically induced,  drug therapy
Leishmaniasis, Visceral / drug therapy*
Potassium Chloride / therapeutic use*
Sodium Chloride / therapeutic use*
Reg. No./Substance:
0/Antiprotozoal Agents; 0/Electrolytes; 1397-89-3/Amphotericin B; 60-27-5/Creatinine; 7447-40-7/Potassium Chloride; 7647-14-5/Sodium Chloride

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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