TY - JOUR
T1 - Efficacy and tolerance of an amphotericm b lipid (intralipid) emulsion in the treatment of candidaemia in neutropenic patients
AU - Caillot, Denis
AU - Casasnovas, Olivier
AU - Solary, Eric
AU - Chavanet, Pascal
AU - Bonnotte, Bernard
AU - Reny, Guillaume
AU - Entezam, Fahrad
AU - Lopez, Jose
AU - Bonnin, Alain
AU - Guy, Henri
N1 - Funding Information:
The authors would like to thank Dr Thomas J. Walsh and Dr Mark Fesen for helpful discussion of the manuscript. This work was supported partly by a grant from INSERM (Contrat Normalise d'Etude Pilote en Recherche Clinique; No. 91CN59).
PY - 1993/1/1
Y1 - 1993/1/1
N2 - The efficacy and tolerance of a new amphotericin B lipid emulsion (AmB-IL) in which amphotericin B was diluted in a lipid solution for parenteral nutrition (Intralipid) was assessed in fourteen episodes of candidaemia occurring in neutropenic patients. The strains isolated were Candida krusei (nine cases), Candida albicans (three cases), Candida parapsilosis (one case) and Candida lusitarnae (one case). An AmB-IL was administered at a mean dosage of 1·18 mg/kg/day (range 0·73-1·55) for 22 days (range 6-62). Flucytosine was added to AmB-IL in 12 patients (mean duration 10·6 days). Chills were noted in only 3/306 infusions of AmB-IL. A mild increase of serum creatinine level from 9·3 ± 3 mg/L (baseline) to 10·9±3 mg/L (after completion of AmB-IL) and mild decrease of creatinine clear ance from 83±28 mL/min to 56±21 mL/min were observed. These changes did not correlate with either daily or total dose of AmB-IL or length of therapy. Seven patients were cured and six improved (patients who subsequently died due to non fungal cause) with AmB-IL. One patient died due to C. krusei pneumonia. In conclusion AmB-IL is a well-tolerated method of arnphotericin B administration. It could facilitate the use of amphotericin B without impairing its efficacy for the treatment of candidaemia in neutropenic patients.
AB - The efficacy and tolerance of a new amphotericin B lipid emulsion (AmB-IL) in which amphotericin B was diluted in a lipid solution for parenteral nutrition (Intralipid) was assessed in fourteen episodes of candidaemia occurring in neutropenic patients. The strains isolated were Candida krusei (nine cases), Candida albicans (three cases), Candida parapsilosis (one case) and Candida lusitarnae (one case). An AmB-IL was administered at a mean dosage of 1·18 mg/kg/day (range 0·73-1·55) for 22 days (range 6-62). Flucytosine was added to AmB-IL in 12 patients (mean duration 10·6 days). Chills were noted in only 3/306 infusions of AmB-IL. A mild increase of serum creatinine level from 9·3 ± 3 mg/L (baseline) to 10·9±3 mg/L (after completion of AmB-IL) and mild decrease of creatinine clear ance from 83±28 mL/min to 56±21 mL/min were observed. These changes did not correlate with either daily or total dose of AmB-IL or length of therapy. Seven patients were cured and six improved (patients who subsequently died due to non fungal cause) with AmB-IL. One patient died due to C. krusei pneumonia. In conclusion AmB-IL is a well-tolerated method of arnphotericin B administration. It could facilitate the use of amphotericin B without impairing its efficacy for the treatment of candidaemia in neutropenic patients.
UR - http://www.scopus.com/inward/record.url?scp=0027478044&partnerID=8YFLogxK
U2 - 10.1093/jac/31.1.161
DO - 10.1093/jac/31.1.161
M3 - Article
C2 - 8444659
AN - SCOPUS:0027478044
SN - 0305-7453
VL - 31
SP - 161
EP - 169
JO - Journal of Antimicrobial Chemotherapy
JF - Journal of Antimicrobial Chemotherapy
IS - 1
ER -