amphotericin b lipid complex compared with amphotericin b in the treatment of cryptococcal meningitis in patients with aids [see comments]

NLM AIDSLINE Amphotericin B lipid complex compared with amphotericin B in the treatment of cryptococcal meningitis in patients with AIDS [see comments] Sharkey PK; Graybill JR; Johnson ES; Hausrath SG; Pollard RB; Kolokathis
February 28, 1997

Clin Infect Dis. 1996 Feb;22(2):315-21. Unique Identifier : AIDSLINE The study objective was to obtain preliminary information regarding the safety and efficacy of amphotericin B (AmB) lipid complex (ABLC) in the treatment of AIDS-associated cryptococcal meningitis. Of 55 patients randomly assigned to 6 weeks of therapy with ABLC (1.2-5.0 mg/[kg.d], with ascending doses for three sequential cohorts) or AmB (0.7-1.2 mg/[kg.d]), 46 received > or = 12 doses. Transfusion requirements, mean decreases in hemoglobin level, and mean increases in creatinine level were significantly greater with AmB than with ABLC. The total number of adverse events, infusion-related events, and occurrences of hypomagnesemia and hypokalemia associated with each form of therapy were similar. Among 21 recipients of ABLC at a dosage of 5 mg/kg (daily for 2 weeks and then thrice weekly for 4 weeks), symptoms and signs resolved for 18 (86%). Of those receiving > or = 12 doses of ABLC, cultures converted to negative for 8 (42%), were undeterminable for 3 (16%), and remained positive for 8 (42%) despite resolution of symptoms. Although preliminary, these data suggest ABLC has significant activity in patients with AIDS-associated cryptococcal meningitis. Because this formulation has less hematologic and renal toxicity than does AmB, further evaluation of ABLC is warranted. Adult Amphotericin B/ADMINISTRATION & DOSAGE/ADVERSE EFFECTS/ THERAPEUTIC USE Antibiotics, Antifungal/ADMINISTRATION & DOSAGE/ADVERSE EFFECTS/ THERAPEUTIC USE Antifungal Agents/ADMINISTRATION & DOSAGE/ADVERSE EFFECTS/ THERAPEUTIC USE AIDS-Related Opportunistic Infections/DRUG THERAPY Cohort Studies Comparative Study Drug Combinations Female Human Male Meningitis, Cryptococcal/DRUG THERAPY Middle Age Phosphatidylcholines/ADMINISTRATION & DOSAGE/ADVERSE EFFECTS/ THERAPEUTIC USE Phosphatidylglycerols/ADMINISTRATION & DOSAGE/ADVERSE EFFECTS/ *THERAPEUTIC USE Support, Non-U.S. Gov't CLINICAL TRIAL JOURNAL ARTICLE MULTICENTER STUDY RANDOMIZED CONTROLLED TRIAL

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Information in this article was accurate in February 28, 1997. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.