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Journal of Antimicrobial Chemotherapy (1992) 30, 535-541
© 1992 The British Society for Antimicrobial Chemotherapy

research-article

Reduced renal toxicity and improved clinical tolerance of amphotericin B mixed with Intralipid compared with conventional amphotericin B in neotropenic patients

Philippe Moreau, Noël Milpied, Nadine Fayette, Jean-François Ramée and Jean-Luc Harousseau

Department of Haematology, CHU Hôtel Dieu 44035 Nantes Cedex 01, France

Received 14 February 1992; returned 2 June 1992; accepted 2 June 1992

The clinical use of amphotericin B is sometimes limited by nephrotoxicity. In a randomized prospective study, 32 patients treated for haematological malignancies received either amphotericin B in 5% dextrose (group A, 16 patients, 0·7–1 mg/kg/day), or amphotericin B mixed with Intralipid (group B, 16 patients, 0·7–1 mg/kg/day) during prolonged neutropenia. Renal dysfunction occurred in 9/16 patients in group A and 2/16 patients in group B (P < 0·05). Clinical tolerance was improved with a reduction of fever with chills in 12/16 patients in group A compared with 5/16 in group B (P<0·05). Preparation of amphotericin B with Intralipid reduces nephrotoxicity, improves clinical tolerance, may allow an increase in the daily dose of amphotericin B, and be an alternative to liposomal-amphotericin B infusion.


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