Khoo S H, Bond J, Denning D W
Regional Department of Infectious Diseases and Tropical Medicine, Monsall Hospital, Manchester, UK.
J Antimicrob Chemother. 1994 Feb;33(2):203-13. doi: 10.1093/jac/33.2.203.
Despite the introduction in recent years of novel antifungal agents, the potency and broad spectrum of activity of amphotericin B have ensured that it remains the treatment of choice for most deep-seated mycoses. However, this agent is not without significant toxicity, particularly in patients who are already seriously ill and/or who are receiving other potentially nephrotoxic drugs. We review the various routes by which amphotericin B can be administered, focusing mainly on the intravenous route. The use of more rapid infusion rates, lipid-complexed preparations, sodium supplementation in salt-depleted patients and strategies to reduce the incidence of infusion-related reactions and nephrotoxicity are also considered. Finally, detailed recommendations for the administration of amphotericin B are provided.
尽管近年来新型抗真菌药物不断问世，但两性霉素B的效力和广泛的活性谱确保了它仍然是大多数深部真菌病的首选治疗药物。然而，这种药物并非没有明显的毒性，特别是在已经病情严重和/或正在接受其他潜在肾毒性药物治疗的患者中。我们回顾了两性霉素B的各种给药途径，主要关注静脉给药途径。还考虑了使用更快的输注速度、脂质复合制剂、对盐缺乏患者补充钠以及降低输注相关反应和肾毒性发生率的策略。最后，提供了两性霉素B给药的详细建议。
