Comparison of Effects and Side Effects of Amphotericin B Deoxycholate Infusion over 6 versus 24 Hours in Children with Cancer.
- Author:
Yong Jik LEE
1
;
Yong Han KIM
;
Jeong Ok HAH
Author Information
1. Department of Pediatrics, Yeungnam University College of Medicine, Daegu, Korea. johah@med.yu.ac.kr
- Publication Type:Original Article
- Keywords:
Amphotericin-B-Deoxycholate;
Children;
Cancer;
Infusion rate
- MeSH:
Amphotericin B*;
Child*;
Creatinine;
Cross-Over Studies;
Deoxycholic Acid*;
Electrolytes;
Fever;
Headache;
Humans;
Hypophosphatemia;
Magnesium;
Pediatrics;
Vomiting
- From:Korean Journal of Pediatric Hematology-Oncology
2003;10(2):223-229
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: This study was performed to compare the effects and side effects of amphotericin B deoxycholate infusion over 6 versus 24 hours in febrile children with cancer. METHODS: Twenty-four children with cancer who were mostly neutropenic, febrile and suspected to have fungal infection and treated with amphotericin B deoxycholate from March 2001 to July 2002 at the Yeungnam University Hospital, Department of Pediatrics were enrolled for a cross-over study. All patients received 0.5 mg/kg amphotericin B deoxycholate infusion for average 7 days by two different infusion rates, one group by continuous infusion over 24 hours and the other by rapid infusion over 6 hours with at least 4 weeks of washout period. The side effects related to the infusion rates, fever, chilling or rigor, vomiting, headache, serum and urine electrolytes, beta2-microglobulin and creatinine clearance were monitored. The effect of amphotericin B deoxycholate infusion were studied by the days required for defervescence. RESULTS: There were no significant differences (P=0.11) in the effects between continuous and rapid infusion. But less side effects of chilling or rigor (P=0.01) were observed when amphotericin B deoxycholate was infused continuously. The serum phosphate (P=0.05) and magnesium (P=0.04) were lower and creatinine clearance was more reduced (P=0.01) when it was infused rapidly. CONCLUSION: Continuous infusion over 24 hours of amphotericin B deoxycholate could reduce the nephrotoxicity, such as hypophosphatemia, hypomagnesemia, low creatinine clearance and chilling reactions related to the rapid infusion without compromising the effects of amphotericin B deoxycholate in children with cancer.
