A double-blind, randomized, controlled trial of amphotericin B colloidal dispersion versus amphotericin B for treatment of invasive aspergillosis in immunocompromised patients Journal Article


Authors: Bowden, R.; Chandrasekar, P.; White, M. H.; Li, X.; Pietrelli, L.; Gurwith, M.; van Burik, J. A.; Laverdiere, M.; Safrin, S.; Wingard, J. R.
Article Title: A double-blind, randomized, controlled trial of amphotericin B colloidal dispersion versus amphotericin B for treatment of invasive aspergillosis in immunocompromised patients
Abstract: We report a randomized, double-blind, multicenter trial in which amphotericin B colloidal dispersion (ABCD [Amphotec]; 6 mg/kg/day) was compared with amphotericin B (AmB; 1.0-1.5 mg/kg/day) for the treatment of invasive aspergillosis in 174 patients. For evaluable patients in the ABCD and AmB treatment groups, respective rates of therapeutic response (52% vs. 51%; P=1.0), mortality (36% vs. 45% P=.4;), and death due to fungal infection (32% vs. 26%; P=.7) were similar. Renal toxicity was lower (25% vs. 49%; P = .002) and the median time to onset of nephrotoxicity was longer (301 vs. 22 days; P<.001) in patients treated. with ABCD. Rates of drug-related toxicity in patients receiving ABCD and AmB, respectively, were 53% versus 30% (chills), 27% versus 16% (fever), 1% versus 4% (hypoxia) and 22% versus 24% (toxicity requiring study drug discontinuation). ABCD appears to have equivalent efficacy and superior renal safety, compared with AmB, in the treatment of invasive aspergillosis. However, infusion-related chills and fever occurred more frequently in patients receiving ABCD than in those receiving AmB.
Keywords: neutropenia; safety; toxicity; antifungal; efficacy; fungal-infections; mycoses; marrow transplant recipients; deoxycholate suspension; empirical-treatment
Journal Title: Clinical Infectious Diseases
Volume: 35
Issue: 4
ISSN: 1058-4838
Publisher: Oxford University Press  
Date Published: 2002-08-01
Start Page: 359
End Page: 366
Language: English
ACCESSION: WOS:000177111700002
DOI: 10.1086/341401
PROVIDER: wos
PUBMED: 12145716
Notes: Presented in part at the 10th International Symposium on Infection in the Immunocompromised Host; 1998 Jun 21-24; Davos, Switzerland -- Source: Wos
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  1. Mary H White
    43 White