Nirasawa M, Sugaya N, Mitamura K, Komiyama T, Kikuchi H, Oikawa T
Keio J Med. 1989 Sep;38(3):319-24. doi: 10.2302/kjm.38.319.
A 1,040-g premature baby was diagnosed to have disseminated candidiasis and treated with amphotericin B (AMB) and 5-fluorocytosine. During the treatment, an unexpectedly large dose of AMB was infused unintentionally. AMB level was as high as 1.73 micrograms/mL soon after 5 mg/kg infusion instead of 0.5 mg/kg. However, it dropped rapidly to 0.83 micrograms/mL after 24 hours. AMB was detected in patient's serum at a higher level than minimal inhibitory concentration as long as one month after treatment was stopped. The patient showed liver dysfunction but no nephrotoxicity. The further studies are needed to establish safe and effective treatment regimen in premature infants with disseminated candidiasis.
一名体重1040克的早产儿被诊断为播散性念珠菌病，并接受了两性霉素B（AMB）和5-氟胞嘧啶治疗。治疗期间，意外无意输注了超大剂量的AMB。在输注5mg/kg而非0.5mg/kg后不久，AMB水平高达1.73微克/毫升。然而，24小时后迅速降至0.83微克/毫升。在停止治疗后长达一个月的时间里，患者血清中检测到的AMB水平高于最低抑菌浓度。该患者出现肝功能障碍，但无肾毒性。需要进一步研究以建立早产儿播散性念珠菌病的安全有效治疗方案。
