Document Detail


Liposomal amphotericin B does not induce nephrotoxicity or renal function impairment in premature neonates.
MedLine Citation:
PMID:  22633524     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Liposomal amphotericin B (LAMB) is frequently administered in NICU to preterm infants <1500 g at birth (VLBW) for treatment of systemic fungal infections (SFI). Concerns exist on safety and tolerability of such drug in patients who are at risk for renal function impairment due to their prematurity.
AIM: To assess the occurrence of renal function impairment related to LAMB in a 10-year cohort of VLBW neonates treated with this drug.
METHODS: Through database search of clinical charts, all VLBW neonates admitted to a 3(rd) level NICU in the years 1998-2007 and undergoing treatment with LAMB were identified. The occurrence of LAMB-attributable renal toxicity was investigated; infants withdrawn from treatment for development of adverse effects or toxicity were identified.
RESULTS: In the study period, 71 of 792 admitted VLBW neonates (8.9%) underwent antifungal treatment with LAMB administered at the recommended dosages (3-to-5 mg/kg/day). Mean duration of treatment was 14 (±9) days, mean cumulative dose given was 58 (±25) mg/kg per infant. Renal compromise, defined as hypokalaemia, and/or elevated creatinine serum levels, and/or decreased urine output, occurred in 2 of 71 (2.8%) treated patients, by 5 (±3) mean days after treatment initiation. In both patients LAMB was withdrawn; renal function impairment was only mild and transient, and normal renal function was restored at discharge. No other significant adverse effects were recorded in any treated neonate.
CONCLUSIONS: LAMB is generally safe and well tolerated in VLBW neonates. The occurrence of LAMB-related nephrotoxicity appears to be uncommon, mild and transient.
Authors:
P Manzoni; P Galletto; S Rizzollo; C Franco; E Gallo; R Antonucci; V Fanos; D Farina
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Early human development     Volume:  88 Suppl 2     ISSN:  1872-6232     ISO Abbreviation:  Early Hum. Dev.     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-05-28     Completed Date:  2012-11-29     Revised Date:  2013-01-30    
Medline Journal Info:
Nlm Unique ID:  7708381     Medline TA:  Early Hum Dev     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  S86-91     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Neonatology and NICU, Sant'Anna Hospital, Azienda Ospedaliera OIRM - S Anna, Torino, Italy. paolomanzoni@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Amphotericin B / adverse effects*,  therapeutic use*
Antifungal Agents / adverse effects*,  pharmacology,  therapeutic use
Candidiasis / drug therapy
Cohort Studies
Creatinine / blood
Fluconazole / therapeutic use
Humans
Hypokalemia / chemically induced
Infant, Newborn
Infant, Premature, Diseases / drug therapy*
Infant, Very Low Birth Weight
Kidney / drug effects
Kidney Diseases / chemically induced*
Kidney Function Tests
Mycoses / drug therapy*
Premature Birth
Retrospective Studies
Sepsis / drug therapy
Chemical
Reg. No./Substance:
0/Antifungal Agents; 0/liposomal amphotericin B; 1397-89-3/Amphotericin B; 60-27-5/Creatinine; 86386-73-4/Fluconazole
Comments/Corrections
Comment In:
Early Hum Dev. 2013 Jan;89(1):37   [PMID:  22831635 ]
Early Hum Dev. 2013 Jan;89(1):35-6   [PMID:  22877627 ]

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


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