| Systemic absorption of amphotericin B with topical 5% mafenide acetate/amphotericin B solution for grafted burn wounds: is it clinically relevant? | |
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MedLine Citation:
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PMID: 19481350 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To determine if patients receiving topical amphotericin B in combination with 5% mafenide acetate solution will acquire systemically detectable levels of amphotericin B. METHODS: A prospective, observational study of consecutive patients from May 2007 to March 2008 who received 5% mafenide acetate/amphotericin B (2 mcg/ml) solution topically every 4h to their excised and grafted burn wounds for at least 5 days. Serum amphotericin B levels were measured every 5 days during treatment. In addition, the percentage of graft take, occurrence of infection, and potential adverse reactions or toxicities were monitored and recorded. RESULTS: A total of 27 patients were enrolled, accumulating 420 treatment days and 72 amphotericin B levels. Sixty-nine of the amphotericin B levels were undetectable, while 3 were detectable at non-therapeutic levels (<0.5 mcg/ml). Of the patients with a detectable serum amphotericin B level, only one experienced adverse reactions that could potentially be attributed to amphotericin B. The mean TBSA burned was 32% (SD+/-14%), with a mean TBSA treated with solution of 21% (SD+/-13%). The median duration of treatment was 8 days (range 5-52 days), and the median number of amphotericin B levels drawn per patient was 1 (range 1-19). The median percentage graft take was 95%, and there were no fungal wound infections. CONCLUSIONS: We conclude that 5% mafenide acetate/amphotericin B (2 mcg/ml) solution, applied to excised and grafted burn wounds, does not produce clinically relevant serum levels of amphotericin B. Based on our observations, this topical regimen is safe. |
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Authors:
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Rachel A Pendleton; James H Holmes |
Publication Detail:
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Type: Clinical Trial; Journal Article Date: 2009-05-29 |
Journal Detail:
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Title: Burns : journal of the International Society for Burn Injuries Volume: 36 ISSN: 1879-1409 ISO Abbreviation: Burns Publication Date: 2010 Feb |
Date Detail:
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Created Date: 2010-02-01 Completed Date: 2010-09-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8913178 Medline TA: Burns Country: Netherlands |
Other Details:
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Languages: eng Pagination: 38-41 Citation Subset: IM |
Copyright Information:
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Copyright (c) 2009 Elsevier Ltd and ISBI. All rights reserved. |
Affiliation:
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North Carolina Baptist Hospital, and Wake Forest University School of Medicine, Winston-Salem, NC 27157, United States. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Cutaneous Amphotericin B / administration & dosage, adverse effects, blood* Anti-Infective Agents / administration & dosage, adverse effects, blood* Anti-Infective Agents, Local / administration & dosage, adverse effects Burns / blood, surgery* Drug Administration Schedule Drug Combinations Graft Survival Humans Mafenide / administration & dosage*, adverse effects Postoperative Care / methods Prospective Studies Skin Absorption Surgical Wound Infection / blood, prevention & control* |
| Chemical | |
Reg. No./Substance:
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0/Anti-Infective Agents; 0/Anti-Infective Agents, Local; 0/Drug Combinations; 138-39-6/Mafenide; 1397-89-3/Amphotericin B |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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