Renal tolerance with the use of intralipid-amphotericin B in low-birth-weight neonates
| Autor: | Philippe Friedlich, Steinberg I, deLemos Ra, Fujitani A |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
Male
medicine.medical_specialty Antifungal Agents Renal function Infant Premature Diseases Urine Kidney Kidney Function Tests Gastroenterology Nephrotoxicity Blood Urea Nitrogen chemistry.chemical_compound Amphotericin B Internal medicine Intensive Care Units Neonatal Candida albicans medicine Humans Registries Mycosis Retrospective Studies Creatinine Analysis of Variance Chi-Square Distribution business.industry Candidiasis Infant Newborn Obstetrics and Gynecology Gestational age Infant Low Birth Weight medicine.disease Surgery Low birth weight Treatment Outcome chemistry Pediatrics Perinatology and Child Health Female medicine.symptom business Fungemia medicine.drug Kidney disease |
| Zdroj: | American journal of perinatology. 14(7) |
| ISSN: | 0735-1631 |
| Popis: | Amphotericin B is still the first-line therapy for neonatal fungal infections. With several comparative trials of intralipid-based amphotericin B (IL-AmB) demonstrating its clinical effectiveness and reduced renal toxicity in adults, we examined the renal tolerance and infection outcome in low-birth-weight infants in our 48-bed NICU treated with IL-AmB. Over 2 years, 52 patients (58 courses) receivedor = 10 days of IL-AmB. Nineteen charts (23 episodes) were randomly accessed and reviewed. Mean birthweight = 747 grams, gestational age = 25.6 weeks, total IL-AmB dosage = 19.8 +/- 3.3 mg/kg (n = 23); 20 of these episodes were fungal culture positive (9 fungemias). Only one patient (who died during therapy) had a rise in creatinine of0.3 mg/dL. Overall, serum creatinine decreased significantly after Day 10 of IL-AmB therapy, from 0.93 +/- 0.42 mg/dL at baseline, to 0.54 +/- 0.24 after 19 days of therapy (p0.0001). Serial urine output, serum potassium and potassium supplementation data showed no significant differences from baseline. No interruption of therapy nor infusion reactions occurred. Only one death occurred attributable to fungal infection. Intralipid-amphotericin B may provide an effective alternative in the antifungal therapy of low birthweight neonates, without nephrotoxicity. Further prospective, comparative trials are warranted. |
| Databáze: | OpenAIRE |
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