Amphotericin B의 투여방법간의 임상적 안전성 및 유효성 비교 = Comparison of the Clinical Safety & Efficacy among three administration methods of Amphotericin B

다국어 초록 (Multilingual Abstract)

Despite of the potential utility of amphotericin B in invasive general fungal infections its adverse events, particulary renal toxicity, are limiting factors in its use. Lipid formulations of amphotericin B are believed to offer a better therapeutic index, but their cost and insurance restriction limit their clinical use. These days many controversal results have been published according to efficacy and safety of simply mixed amphotericin B in lipid emulsion. So we conducted retrospective chart review study to compare efficacy and safety of simply mixed amphotericin B with lipid emulsion(A) to liposomal amphotericin B(B) and amphotericin B in 5% dextrose water(C). Among the medical chart of C hospital from January, 2000 to December, 2001 total 59 case of amphotericin B applications were selected. Safety of each methods evaluated by ΔScr, ΔBUN, ΔK. The patients receiving (A) showed the lowest ΔScr(-1±2.79. p=2.59), ΔBUN(2.04±22.69, p=0.24) whereas (B) (-0.31±1.36, 14.66±20.74, p=0.5) and (C) (0.19±0.45, 7.97±12.21) showed moderately high score. However the percentage of patients who need to receive potassium to adjust hypokalemia were 25% in (B), 50% in (A), 65% in (C). Additional laboratory certification of physical and chemical stability of (A) and clinical prospective study are essential to define potential difference in safety and efficacy of each methods.