Τίτλος:
Liposomal amphotericin B in critically ill paediatric patients
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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.
Συγγραφείς:
Sideri, G.
Falagas, M.E.
Grigoriou, M.
Vouloumanou, E.K.
Papadatos, J.H.
Lebessi, E.
Kafetzis, D.A.
Περιοδικό:
Journal of Clinical Pharmacy and Therapeutics
Λέξεις-κλειδιά:
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
DOI:
10.1111/j.1365-2710.2011.01288.x
