Abstract

Background: Amphotericin B is efficacious for the treatment of systemic candidiasis, however it has,potentially serious toxic effects. Administration as lipid emulsions has been aduocated to decrease its toxicity. Aim: To compare the safety aid tolerance of amphotericin B administered as lipid emulsion or dissolved ill dextrose in water. Patients and methods: Forty five patients with confirmed or highly suspected systemic candidiasis were studied. Between January 1996 and June 1997 amphotericin B was administered ill dextrose ill water to 17 patients (group 1). Between July 1997 and December 1998, the drug was delivered in lipid emulsions (Intralipid, group 2). Clinical and laboratory parameters (serum creatinine, urea nitrogen and potassium), were assessed daily. Results: Both treatment groups were clinically comparable and had the same survival. Accumulative amphotericin B dose administered was 343.2 +/- 197 and 414.6 +/- 518 mg respectively. Hypokalemia was more frequent ill group 2 (52 and 25 % respectively p < 0.05). There were no differences iii the outcome of renal function or other adverse reactions. Conclusions: Administration of amphotericin B as lipid emulsions did not reduce its toxicity in critical patients.