We conducted a prospective, randomized, double-blind study comparing amphotericin B colloidal dispersion (ABCD) with amphotericin B in the empirical treatment of fever and neutropenia. Patients with neutropenia and unresolved fever after > or = 3 days of empirical antibiotic therapy were stratified by age and concomitant use of cyclosporine or tacrolimus. Patients were then randomized to receiv...

The pharmacokinetics of amphotericin B were studied in two patients at the conclusion of long-term therapy for disseminated histoplasmosis. The distribution kinetics of this drug were adequately described by a three-compartment mamillary model with a total distribution volume averaging 4 liters/kg. The elimination phase half-life of amphotericin B was approximately 15 days, reflecting slow rele...

INTRODUCTION The aim of the present study was to compare the changing pattern of urine neutrophil gelatinase-associated lipocalin (NGAL) with serum as well as urine creatinine during amphotericin B treatment and determine its accuracy in the early detection of amphotericin B nephrotoxicity. MATERIALS AND METHODS A cohort study was performed during 9 months at 3 hematology-oncology services. P...

The antifungal antibiotic amphotericin B causes considerable toxic effects during clinical therapy. We have shown previously that amphotericin B-induced cytotoxicity and apoptosis were eradicated by the Na+, K+, 2Cl- cotransport inhibitor bumetanide. To elucidate the role of K+ flux and the activity of Na+, K+ ATPase and Na+, K+, 2Cl- cotransport in apoptosis and cytotoxicity induced by amphote...

Background: The use of antifungal agents has been increasing in the growing population of immunocompromised patients. To address the problem of renal and infusion-related toxic effects of conventional amphotericin B, several lipid-based formulations of this drug have been developed. At the authors’ pediatric institution, recommendations for the use of these products were established in 2001. Ob...

In the United States, only 10 antifungal drugs are currently approved by the Food and Drug Administration (FDA) for the therapy of systemic fungal infections. As shown in table 1, these drugs belong to 3 principal classes: polyenes, pyrimidines, and azoles. Drugs that belong to other classes are also approved as topical antifungal drugs, but will not be considered further here. Although convent...

The in vitro activities of liposome-encapsulated amphotericin B and free amphotericin B against Candida albicans 336 were comparable. Amphotericin B concentrations 12-fold and greater than 50-fold higher were required to kill the same organism when cholesterol and ergosterol were incorporated into the liposomes. The addition of cholesterol to liposomes caused a significant increase in the minim...

Amphotericin B treatment during extracorporeal membrane oxygenation is at times necessary for the treatment of secondary fungemia or, less commonly, to treat a primary fungal infection. The impact of the extracorporeal circuit on the pharmacokinetics of amphotericin B have not been described in vivo. This case report describes the pharmacokinetics of amphotericin B in a patient receiving extrac...