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[Amphotericin B deoxycholate prescription and adverse events in a Chilean university hospital]. / Uso de anfotericina B deoxicolato y sus reacciones adversas en un hospital universitario en Chile.
Quinteros A, Roxanna; Fica C, Alberto; Abusada A, Nancy; Muñoz C, Lorena; Novoa M, Catalina; Gallardo A, Carlos.
Afiliação
  • Quinteros A R; Servicio de Infectología, Hospital Militar de Santiago, Chile.
Rev Chilena Infectol ; 27(1): 25-33, 2010 Feb.
Article em Es | MEDLINE | ID: mdl-20140311
UNLABELLED: Amphotericin B deoxycholate is associated with infusion-related toxicity and renal toxicity. PURPOSE: To evaluate medical indications of this compound in a tertiary care center, analyze adverse reactions, infusion protocols and outcome of treated patients. PATIENTS AND METHODS: Retrospective analysis of 39 treatments indicated in 33 patients during 2007, exploring indications, infusion protocols and renal protective measures, infusion-related adverse reactions, nephrotoxicity, hypokalemia and outcomes. RESULTS: On average, therapy lasted 12 days (2 to 39) and reached 600 mg of accumulated dose (100 to 1950) respectively. 24-hours infusions were applied in 63.2% of prescriptions and 35.9% received a 4-6 hour infusion schedule. In addition, 36.8% received daily a saline infusion before amphotericin. Adverse reactions were observed in 40% of treatments, predominating fever (25%). Nonetheless, nephrotoxicity was infrequent (9.4%), of low magnitude, only affecting patients without previous renal disease, and not requiring dialysis. Hypokalemia developed in 21.6% of treatments. More than half of medical indications were empirical (59%), for presumed infections by either filamentous fungi or yeasts. In the subgroup with microbiological information, main indications were invasive aspergillosis (15.4% of total), systemic candidiasis (12.8%) or meningeal cryptococcosis (10.3%). A favorable response was registered in 41%, and only 48.5% of patients survived. In a multivariate analysis, only age > 60 years remained as an independent factor for developing infusion-related adverse reactions. In the same manner, a SOFA score > 3 and corticosteroids administration at the same time than amphotericin B, were independently associated to a fatal outcome. CONCLUSION: infusion-related adverse reactions are frequent during amphotericin B deoxycholate therapy, but renal toxicity is occasionally observed. Amphotercin B was used mainly as empirical therapy in this study.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Anfotericina B / Ácido Desoxicólico / Micoses / Antifúngicos Tipo de estudo: Guideline / Observational_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Chile Idioma: Es Revista: Rev Chilena Infectol Ano de publicação: 2010 Tipo de documento: Article País de afiliação: Chile País de publicação: Chile

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Anfotericina B / Ácido Desoxicólico / Micoses / Antifúngicos Tipo de estudo: Guideline / Observational_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Chile Idioma: Es Revista: Rev Chilena Infectol Ano de publicação: 2010 Tipo de documento: Article País de afiliação: Chile País de publicação: Chile