O'Horo John C, Osmon Douglas R, Abu Saleh Omar M, Marcelin Jasmine R, Gharaibeh Kamel A, Hamadah Abdurrahman M, Barwise Amelia K, Kayhart Bryce M, McDonald Jennifer S, McDonald Robert J, Leung Nelson
Division of Infectious Diseases, Rochester, Minnesota, USA
Division of Pulmonary and Critical Care Medicine, Rochester, Minnesota, USA.
Antimicrob Agents Chemother. 2017 Jul 25;61(8). doi: 10.1128/AAC.00323-17. Print 2017 Aug.
Intravenous radiographic contrast medium and amphotericin B are commonly required in the care of patients with fungal infections. Both interventions have proposed nephrotoxicity through similar mechanisms. We systematically examined patients who received coadministration of liposomal amphotericin B (AmBisome; GE Healthcare) and intravenous contrast medium within a 24-h period and compared the results for those patients with the results for patients who underwent non-contrast medium studies. We found 114 cases and 85 controls during our study period. Overall, no increased risk of renal injury was seen with coadministration of these 2 agents. Adjustment for age, baseline kidney function, and other clinical factors through propensity score adjustment did not change this result. Our observations suggest that, when clinically indicated, coadministration of contrast medium and liposomal amphotericin B does not present excess risk compared with that from the administration of liposomal amphotericin B alone.
真菌感染患者的护理中通常需要静脉注射放射造影剂和两性霉素B。这两种干预措施都通过类似机制引发潜在肾毒性。我们系统地检查了在24小时内同时接受脂质体两性霉素B（安必素；通用电气医疗集团）和静脉造影剂的患者，并将这些患者的结果与未接受造影剂检查的患者结果进行比较。我们在研究期间发现了114例病例和85例对照。总体而言，这两种药物同时使用时，未见肾损伤风险增加。通过倾向评分调整对年龄、基线肾功能和其他临床因素进行校正后，这一结果并未改变。我们的观察结果表明，在有临床指征时，与单独使用脂质体两性霉素B相比，造影剂与脂质体两性霉素B同时使用不会带来额外风险。
