Please use this identifier to cite or link to this item: https://ninho.inca.gov.br/jspui/handle/123456789/13898
Title: Comparison of the Toxicity of Amphotericin B in 5% Dextrose with That of Amphotericin B in Fat Emulsion in a Randomized Trial with Cancer Patients
Authors: Nucci, Marcio Luiz Moore
Loureiro, Monique Morgado
Casali, Anna Raquel de Lima
Bouzas, Luis Fernando da Silva
Velasco, Eduardo
Spector, Nelson
Pulcheri, Wolmar de Alcantara
Keywords: Toxicidade
Toxicity
Anfotericina B
Amphotericin B
Glucose
Emulsões
Emulsions
Embolia Gordurosa
Embolism Fat
Ensaio Clínico Controlado Aleatório
Randomized Controlled Trial
Neoplasias
Neoplasms
Pacientes
Patients
Issue Date: Jun-1999
Abstract: A multicentric randomized trial was undertaken to compare the toxicity of amphotericin B in 5% dextrose with that of amphotericin B in a fat emulsion (Intralipid) in cancer patients. Group 1 (n 5 33) received amphotericin B diluted in 5% dextrose with premedication consisting of promethazine plus an antipyretic. Group 2 (n 5 28) received amphotericin B diluted in 20% Intralipid without premedication. Amphotericin B was infused daily at a dose of 1 mg/kg of body weight over a 1-h period to members of both groups for empirical antifungal therapy (in neutropenic patients) or for the treatment of documented fungal infections. The majority of patients (80%) received empirical amphotericin B treatment. The two groups were comparable with regard to age, gender, underlying disease, and the following baseline characteristics: use of other nephrotoxic drugs and serum levels of potassium and creatinine. The median cumulative doses of amphotericin B were 240 mg in group 1 and 245 mg in group 2 (P 5 0.73). Acute adverse events occurred in 88% of patients in group 1 and in 71% of those in group 2 (P 5 0.11). Forty percent of the infusions in group 1 were associated with fever, compared to 23% in group 2 (P < 0.0001). In addition, patients in group 2 required less meperidine for the control of acute adverse events (P 5 0.008), and fewer members of this group presented with hypokalemia (P 5 0.004) or rigors (P < 0.0001). There was no difference in the proportions of patients with nephrotoxicity (P 5 0.44). The success rates of empirical antifungal treatment were similar in the two groups (P 5 0.9). Ampho tericin B diluted in a lipid emulsion seems to be associated with a smaller number of acute adverse events and fewer cases of hypokalemia than amphotericin B diluted in 5% dextrose.
URI: https://ninho.inca.gov.br/jspui/handle/123456789/13898
ISSN: 1098-6596
Appears in Collections:Hospital do Câncer I (HCI)



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