Unbound MEDLINE

Liposomal amphotericin B does not induce nephrotoxicity or renal function impairment in premature neonates.

Abstract

BACKGROUND
Liposomal amphotericin B (LAMB) is frequently administered in NICU to preterm infants <1500 g at birth (VLBW) for treatment of systemic fungal infections (SFI). Concerns exist on safety and tolerability of such drug in patients who are at risk for renal function impairment due to their prematurity.
AIM
To assess the occurrence of renal function impairment related to LAMB in a 10-year cohort of VLBW neonates treated with this drug.
METHODS
Through database search of clinical charts, all VLBW neonates admitted to a 3(rd) level NICU in the years 1998-2007 and undergoing treatment with LAMB were identified. The occurrence of LAMB-attributable renal toxicity was investigated; infants withdrawn from treatment for development of adverse effects or toxicity were identified.
RESULTS
In the study period, 71 of 792 admitted VLBW neonates (8.9%) underwent antifungal treatment with LAMB administered at the recommended dosages (3-to-5 mg/kg/day). Mean duration of treatment was 14 (±9) days, mean cumulative dose given was 58 (±25) mg/kg per infant. Renal compromise, defined as hypokalaemia, and/or elevated creatinine serum levels, and/or decreased urine output, occurred in 2 of 71 (2.8%) treated patients, by 5 (±3) mean days after treatment initiation. In both patients LAMB was withdrawn; renal function impairment was only mild and transient, and normal renal function was restored at discharge. No other significant adverse effects were recorded in any treated neonate.
CONCLUSIONS
LAMB is generally safe and well tolerated in VLBW neonates. The occurrence of LAMB-related nephrotoxicity appears to be uncommon, mild and transient.

Links

  • Publisher Full Text

    • Authors

    Manzoni P, Galletto P, Rizzollo S, Franco C, Gallo E, Antonucci R, Fanos V, Farina D

    Institution

    Neonatology and NICU, Sant'Anna Hospital, Azienda Ospedaliera OIRM - S Anna, Torino, Italy. paolomanzoni@hotmail.com

    Source

    Early human development 88 Suppl 2: 2012 May pg S86-91

    MeSH

    Amphotericin B
    Antifungal Agents
    Candidiasis
    Cohort Studies
    Creatinine
    Fluconazole
    Humans
    Hypokalemia
    Infant, Newborn
    Infant, Premature, Diseases
    Infant, Very Low Birth Weight
    Kidney
    Kidney Diseases
    Kidney Function Tests
    Mycoses
    Premature Birth
    Retrospective Studies
    Sepsis

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    22633524