Document Detail


Intradialytic administration of amphotericin B: clinical observations on efficacy and safety.
MedLine Citation:
PMID:  14722389     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
James E Wood; Mary P Mahnensmith; Rex L Mahnensmith; Mark A Perazella
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Publication Detail:
Type:  Journal Article    
Journal Detail:
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:
Created Date:  2004-01-14     Completed Date:  2004-02-19     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370506     Medline TA:  Am J Med Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  5-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Yale University School of Medicine, New Haven, CT 06520, USA.
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MeSH Terms
Descriptor/Qualifier:
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:
0/Antifungal Agents; 0/Hemodialysis Solutions; 1397-89-3/Amphotericin B

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