Document 0263
 DOCN  M94A0263
 TI    Liposomal amphotericin B, AmBisome.
 DT    9412
 AU    Hay RJ; United Medical School, Guys Hospital, London, U.K.
 SO    J Infect. 1994 May;28 Suppl 1:35-43. Unique Identifier : AIDSLINE
       MED/94358455
 AB    The unilamellar liposomal formulation of amphotericin B, AmBisome, is
       composed of hydrogenated soy phosphatidylcholine, distearoyl
       phosphatidylglycerol and cholesterol. Early studies of its efficacy in
       an open design showed that remissions could be induced in candidosis and
       aspergillosis and that doses of up to 5 mg/kg could be used. Adverse
       events were infrequent, with the main abnormality seen being
       hypokalaemia in about 18% of patients. Subsequent developments have
       extended this work. AmBisome has been used in two open studies of
       patients with invasive aspergillosis; in one of these remission was
       achieved in 77% of 17 patients with confirmed infection who had failed
       to respond to conventional amphotericin B. In AIDS patients with
       cryptococcosis AmBisome given for 6 weeks at 3 mg/kg daily produced
       mycological remission of meningitis in 67%. Other infections treated
       with the drug include zygomycete (mucormycosis) and Fusarium infections.
       AmBisome has also been used as preventative therapy in bone marrow
       transplant recipients and was found to reduce fungal colonisation rates.
       There were fewer systemic fungal infections in the treated versus
       placebo groups although this did not achieve statistical significance.
       Lack of renal and liver toxicity or anaemia has been confirmed in
       subsequent studies. In addition febrile reactions to the AmBisome are
       rare. The drug has also been used effectively in children, including
       infants, with systemic fungal infections. In visceral leishmaniasis
       patients, including HIV positive individuals, remissions have been
       obtained using drug regimens of 1-2 mg/kg of 2.1 days and 3 mg/kg for 10
       days.
 DE    Amphotericin B/ADMINISTRATION & DOSAGE/PHARMACOLOGY/*THERAPEUTIC  USE
       Aspergillosis/DRUG THERAPY  Clinical Trials  Comparative Study
       Cost-Benefit Analysis  Cryptococcosis/DRUG THERAPY  Drug Carriers  Human
       Liposomes  Mycoses/*DRUG THERAPY/PREVENTION & CONTROL  JOURNAL ARTICLE
       REVIEW  REVIEW, TUTORIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).