Treatment of Invasive Fungal Infections in Renally Impaired Patients with Amphotericin B Colloidal Dispersion

Author:

Anaissie Elias J.1,Mattiuzzi Gloria N.2,Miller Carole B.3,Noskin Gary A.4,Gurwith Marc J.5,Mamelok Richard D.5,Pietrelli Larry A.5

Affiliation:

1. University of Arkansas for Medical Sciences, Little Rock, Arkansas1;

2. Unidad Onco-Hematologica, San Carlos de Bariloche, Argentina2;

3. The Johns Hopkins University School of Medicine, Baltimore, Maryland3;

4. Northwestern Memorial Hospital and Northwestern University Medical School, Chicago, Illinois4; and

5. SEQUUS Pharmaceuticals, Inc., Menlo Park, California5

Abstract

ABSTRACT Amphotericin B colloidal dispersion (ABCD) is a new formulation of conventional amphotericin B designed to minimize drug distribution in the kidney and reduce nephrotoxicity. We studied the safety and efficacy of ABCD in 133 renally compromised patients with invasive fungal infections. Patients had either nephrotoxicity from amphotericin B or preexisting renal disease. Intravenous treatment with ABCD (4 mg/kg of body weight daily) was administered for up to 6 weeks. Evaluations included clinical response to treatment and adverse events, with emphasis on changes in serum creatinine levels. ABCD did not appear to have an adverse effect on renal function: mean serum creatinine level tended to decrease slightly with days on therapy, and increases were not dose related. Complete or partial response to treatment was reported for 50% of the 133 intent-to-treat patients and 67% of the 58 evaluable patients.

Publisher

American Society for Microbiology

Subject

Infectious Diseases,Pharmacology (medical),Pharmacology

Reference26 articles.

1. Dose-dependent antifungal activity and nephrotoxicity of amphotericin B colloidal dispersion in experimental pulmonary aspergillosis

2. Anaissie E. J. Gurwith M. J. Safety and efficacy of amphotericin B colloidal dispersion (ABCD). 19th International Chemotherapy Conference Montreal Canada July 16–21 1995

3. Invasive candidiasis during granulocytopenia.;Anaissie E. J.;Recent Results Cancer Res.,1993

4. Anaissie E. J. White M. Uzun O. Singer C. Bodey G. P. Matzke D. Azarnia N. Lopez-Berestein G. Amphotericin B lipid complex (ABLC) versus amphotericin B (AMB) for treatment of hematogenous and invasive candidiasis: a prospective randomized multicenter trial abstr. LM21 Abstracts of the 35th Interscience Conference on Antimicrobial Agents and Chemotherapy. 1995 330 American Society for Microbiology Washington D.C

5. Phase I study of amphotericin B colloidal dispersion for the treatment of invasive fungal infections after marrow transplant.;Bowden R. A.;J. Infect. Dis.,1996

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