TY - JOUR
TI - Liposomal amphotericin B in critically ill paediatric patients
AU - Sideri, G.
AU - Falagas, M.E.
AU - Grigoriou, M.
AU - Vouloumanou, E.K.
AU - Papadatos, J.H.
AU - Lebessi, E.
AU - Kafetzis, D.A.
JO - Journal of Clinical Pharmacy and Therapeutics
PY - 2012
VL - 37
TODO - 3
SP - 291-295
PB - 
SN - null
TODO - 10.1111/j.1365-2710.2011.01288.x
TODO - amphotericin B lipid complex;  voriconazole, article;  child;  clinical article;  critically ill patient;  drug effect;  drug efficacy;  drug safety;  drug withdrawal;  female;  human;  hypokalemia;  hyponatremia;  infant;  infection prevention;  liver toxicity;  male;  mycosis;  nephrotoxicity;  preschool child;  systemic mycosis, Amphotericin B;  Antifungal Agents;  Child, Preschool;  Comorbidity;  Drug Monitoring;  Drug-Induced Liver Injury;  Female;  Greece;  Hospitals, Pediatric;  Humans;  Hypokalemia;  Hyponatremia;  Infant;  Intensive Care Units, Pediatric;  Liposomes;  Male;  Mycoses;  Neoplasms;  Prospective Studies;  Renal Insufficiency
TODO - What is known and Objective: Literature provides much evidence regarding liposomal amphotericin B treatment for fungal infections in neonates and infants. Relevant data regarding critically ill paediatric patients of older age are scarce. We aimed to present our experience regarding liposomal amphotericin B use in critically ill paediatric patients from a tertiary-care paediatric hospital in Athens, Greece. Methods: We prospectively identified all paediatric patients who received treatment with liposomal amphotericin B in the intensive care unit of a tertiary-care paediatric hospital during a 3-year period (2005-2008). Data were retrieved from the evaluation of the available medical records. Results and Discussion: Twenty-three (nine females, mean age: 26.4 months, range: 5-39 months) critically ill paediatric patients were included; 12 had malignancy. In 16 of the 23 included children, liposomal amphotericin B was administered for the treatment of confirmed fungal infections (all but one were invasive), whereas in seven patients, it was used as pre-emptive treatment. One patient received voriconazole concomitantly. Eleven of the 16 children with documented infections were cured; five improved. Six of the seven children who received pre-emptive treatment also showed clinical improvement. Nine deaths were noted, all attributed to underlying diseases. Two cases of hepatotoxicity and one case of nephrotoxicity (all leading to drug-discontinuation) occurred. Seven and five cases of mild reversible hypokalaemia and hyponatraemia, respectively, were also noted. What is new and Conclusion: According to the findings of our small case series, liposomal amphotericin B may provide a useful treatment option for fungal infections of vulnerable critically ill paediatric patients with considerable comorbidity. © 2011 Blackwell Publishing Ltd.
ER -