Increased level/dose ratio of amphotericin-B in premature infants with renal failure
| Autor: | Seiji Iwahashi, Ryuzo Higuchi, Hiroshi Ban, Michio Koike, Keiichiro Sumiyama, Masakazu Kobayashi, Sachiko Kusumoto |
|---|---|
| Rok vydání: | 1993 |
| Předmět: |
medicine.medical_specialty
Time Factors Microgram Urine Infant Premature Diseases Gastroenterology Nephrotoxicity chemistry.chemical_compound Serum Bactericidal Test Amphotericin B Internal medicine medicine Humans Infusions Intravenous Disseminated intravascular coagulation Creatinine business.industry Candidiasis Infant Newborn Acute Kidney Injury Infant Low Birth Weight medicine.disease Surgery chemistry Pediatrics Perinatology and Child Health Systemic candidiasis business medicine.drug |
| Zdroj: | Acta paediatrica Japonica : Overseas edition. 35(3) |
| ISSN: | 0374-5600 |
| Popis: | We introduced continuous intravenous infusion of amphotericin-B (AMPH-B) to extremely low birthweight (ELBW) infants (< 1000 g) with or without renal failure as a single agent for treating definite or probable systemic candidiasis. The species of Candida isolated from blood or tracheal aspirate or urine were C. albicans in seven infants, C glabrata in two, C. tropicalis in one and C. parapsilosis in one. The minimal inhibitory concentrations (MIC) of AMPH-B required against these isolates were less than 0.2 micrograms/mL except for that against one strain of C. albicans (0.78 microgram/mL). Serum AMPH-B levels were 0.31-0.78 (0.51 +/- 0.14) micrograms/mL when doses of 0.2-0.55 (0.32 +/- 0.11) mg/kg per day were being administered. The serum level was higher than the MIC of each isolate in all but one infant who died of disseminated intravascular coagulation and Candida pneumonia. Another infant died of congenital heart disease. The other nine infants survived. The serum level showed no correlation with the daily dose. The ratio of the serum level to the daily dose (L/D ratio) showed a significant correlation to serum creatinine (r = 0.787) and the linear regression curve followed the equation: L/D ratio = 0.223 x serum creatinine + 1.11 (P < 0.01). Few adverse effects due to AMPH-B were noted. Our data may give a simple reference to serum AMPH-B levels during continuous intravenous infusion from the dose and the serum creatinine level. |
| Databáze: | OpenAIRE |
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