| Intradialytic administration of amphotericin B: clinical observations on efficacy and safety. | |
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MedLine Citation:
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PMID: 14722389 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Amphotericin B is used commonly to treat fungal infections. Unfortunately, little information exists regarding the use of intravenous amphotericin B in patients with end-stage renal disease (ESRD). METHODS: We retrospectively reviewed the clinical course of patients receiving amphotericin B during hemodialysis (HD). Twenty-five episodes of systemic fungal infection occurring in 24 patients with ESRD treated with parenteral amphotericin B administered during HD were noted. Patients received a maintenance dose of 0.5 to 1.0 mg/kg amphotericin B intravenously thrice weekly during HD sessions. Twenty-three patients received either 500 or 1000 mg of amphotericin B, whereas 1 patient with AIDS received a total of 6,500 mg. RESULTS: Intradialytic hypotension developed in 27.7% of HD sessions during treatment with amphotericin B compared with 28.8% of 20 HD sessions evaluated before initiation of amphotericin B therapy. Four patients exhibited a temperature rise greater than 38.8 degrees C during drug infusion (1 episode per patient). Increases in heart rate and ventricular ectopy were rare. Serum potassium concentrations as well as Kt/V and urea reduction ratio did not change significantly. All patients (except the patient with AIDS) resolved their respective fungal infections. CONCLUSIONS: Intradialytic administration of amphotericin B was generally well tolerated. Our observations suggest that amphotericin B is effective and safe for outpatient intradialytic therapy when administered according to protocol. |
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Authors:
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James E Wood; Mary P Mahnensmith; Rex L Mahnensmith; Mark A Perazella |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The American journal of the medical sciences Volume: 327 ISSN: 0002-9629 ISO Abbreviation: Am. J. Med. Sci. Publication Date: 2004 Jan |
Date Detail:
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Created Date: 2004-01-14 Completed Date: 2004-02-19 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0370506 Medline TA: Am J Med Sci Country: United States |
Other Details:
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Languages: eng Pagination: 5-8 Citation Subset: AIM; IM |
Affiliation:
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Department of Medicine, Yale University School of Medicine, New Haven, CT 06520, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Amphotericin B / administration & dosage*, adverse effects, therapeutic use Antifungal Agents / administration & dosage*, adverse effects, therapeutic use Hemodialysis Solutions / administration & dosage*, adverse effects, therapeutic use Humans Kidney Failure, Chronic / complications* Middle Aged Mycoses / drug therapy*, etiology Renal Dialysis / adverse effects Retrospective Studies Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Antifungal Agents; 0/Hemodialysis Solutions; 1397-89-3/Amphotericin B |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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