Beović B, Lejko-Zupanc T, Pretnar J
Department of Infectious Diseases, University Medical Center Ljubljana, Slovenia.
Eur J Clin Microbiol Infect Dis. 1997 Jul;16(7):507-11. doi: 10.1007/BF01708233.
Amphotericin B colloidal dispersion (ABCD) is a novel lipid formulation of amphotericin B designed to diminish toxic effects of the drug. In the following report, nine cases of suspected (n = 4) and proven (n = 5) deep Candida infection, treated sequentially with amphotericin B deoxycholate and ABCD, are presented. The treatment was successful in seven cases. During treatment with amphotericin B deoxycholate, a rise in serum creatinine was observed in seven patients, hypokalemia in five, and metabolic acidosis in four. After replacing amphotericin B deoxycholate with ABCD, laboratory parameters improved in four of the seven patients with increased creatinine, in four of the five patients with hypokalemia, and in two of the four patients with metabolic acidosis. Infusion-related rigors were observed in four patients receiving amphotericin B deoxycholate and in one patient treated with ABCD. Reversible elevation of liver enzymes was found in one patient receiving ABCD. In this study ABCD proved less toxic than amphotericin B deoxycholate. The efficacy of ABCD alone cannot be assessed because of previous treatment with amphotericin B deoxycholate, but sequential treatment of deep Candida infections with amphotericin B deoxycholate and ABCD seems to be an effective therapeutic modality, especially in patients requiring prolonged administration of amphotericin B.
两性霉素B胶体分散体（ABCD）是两性霉素B的一种新型脂质制剂，旨在减少该药物的毒性作用。在以下报告中，介绍了9例疑似（n = 4）和确诊（n = 5）的深部念珠菌感染病例，这些病例先后接受了脱氧胆酸盐两性霉素B和ABCD治疗。7例治疗成功。在使用脱氧胆酸盐两性霉素B治疗期间，7例患者血清肌酐升高，5例低钾血症，4例代谢性酸中毒。用ABCD替代脱氧胆酸盐两性霉素B后，7例肌酐升高患者中的4例、5例低钾血症患者中的4例以及4例代谢性酸中毒患者中的2例实验室指标有所改善。4例接受脱氧胆酸盐两性霉素B治疗的患者和1例接受ABCD治疗的患者出现了与输液相关的寒战。1例接受ABCD治疗的患者出现了肝酶可逆性升高。在本研究中，ABCD的毒性比脱氧胆酸盐两性霉素B小。由于之前使用过脱氧胆酸盐两性霉素B，因此无法评估ABCD单独使用的疗效，但先用脱氧胆酸盐两性霉素B，再用ABCD序贯治疗深部念珠菌感染似乎是一种有效的治疗方式，特别是在需要长期使用两性霉素B的患者中。
