Document Detail


Systemic absorption of amphotericin B with topical 5% mafenide acetate/amphotericin B solution for grafted burn wounds: is it clinically relevant?
MedLine Citation:
PMID:  19481350     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Rachel A Pendleton; James H Holmes
Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2009-05-29
Journal Detail:
Title:  Burns : journal of the International Society for Burn Injuries     Volume:  36     ISSN:  1879-1409     ISO Abbreviation:  Burns     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-01     Completed Date:  2010-09-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8913178     Medline TA:  Burns     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  38-41     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2009 Elsevier Ltd and ISBI. All rights reserved.
Affiliation:
North Carolina Baptist Hospital, and Wake Forest University School of Medicine, Winston-Salem, NC 27157, United States.
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MeSH Terms
Descriptor/Qualifier:
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:
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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