Department of Pharmacy, Ann & Robert H. Lurie Children's Hospital, Chicago, Illinois.
Lurie Children's Pediatric Research & Evidence Synthesis Center (PRECIISE; A JBI Affiliated Group), Chicago, Illinois; Department of Clinical and Organizational Development, Ann & Robert H. Lurie Children's Hospital, Chicago, Illinois.
Clin Ther. 2021 Oct;43(10):1689-1704. doi: 10.1016/j.clinthera.2021.09.011. Epub 2021 Oct 23.
Amphotericin B has been reported to cause infusion-related adverse effects (IRAEs). To prevent IRAEs, pre-medications may be administered prior to the administration of amphotericin B. The effects of different formulations of amphotericin B (amphotericin B deoxycholate and lipid formulations), duration of infusion, and utility of pre-medications in preventing IRAEs are reviewed.
PubMed, Ovid Medline, Embase, Web of Science, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and the Scopus databases were searched with the following search terms: pre-medication, amphotericin B, and its related compounds. Upon review, a total of 39 publications were considered for inclusion.
In vitro and in vivo studies have reported that amphotericin B deoxycholate stimulates pro-inflammatory cytokine genes causing IRAEs. Nonetheless, the clinical literature has reported that IRAEs occur among patients who received pre-medications. In comparison to amphotericin B deoxycholate, lipid-based formulations of amphotericin may result in a lower or similar risk for IRAEs.
The routine use of pre-medications to prevent IRAEs after the administration of amphotericin B (amphotericin B deoxycholate or lipid formulations) would not be warranted.
已有报道称两性霉素 B 会引起输注相关不良反应（IRAEs）。为了预防 IRAEs，可以在给予两性霉素 B 之前给予预用药。本文综述了两性霉素 B 的不同制剂（两性霉素 B 去氧胆酸盐和脂质制剂）、输注时间以及预用药在预防 IRAEs 中的作用。
使用预用药、两性霉素 B 及其相关化合物等检索词，在 PubMed、Ovid Medline、Embase、Web of Science、Cochrane 系统评价数据库、Cochrane 对照试验中心注册库和 Scopus 数据库中进行检索。经审查，共纳入 39 篇相关文献。
体外和体内研究报告称，两性霉素 B 去氧胆酸盐刺激促炎细胞因子基因，导致 IRAEs。尽管如此，临床文献报告称，接受预用药的患者仍会发生 IRAEs。与两性霉素 B 去氧胆酸盐相比，两性霉素 B 的脂质制剂可能会导致 IRAEs 的风险降低或相似。
两性霉素 B（两性霉素 B 去氧胆酸盐或脂质制剂）给药后常规使用预用药预防 IRAEs 可能没有必要。
