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M94A0263.TXT
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1994-10-08
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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).