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논문 기본 정보

자료유형
학술저널
저자정보
저널정보
한국임상약학회 한국임상약학회지 한국임상약학회지 제22권 제4호
발행연도
2012.1
수록면
340 - 346 (7page)

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Background: Amphotericin B is a mainstay in the treatment of many systemic fungal infections due to its wide antifungal spectrum and low incidence of resistance. However, the use of amphotericin B is limited by its nephrotoxicity. Objectives: The objective of this study was to evaluate the incidence and risk factors of renal adverse drug reactions (ADRs) of conventional amphotericin B (Fungizone®). In addition, we compared the changes of serum creatinine (SCr)between patients who remained conventional amphotericin B and patients who were switched to liposomal amphotericin B after occurrence of renal adverse reactions. Methods: Adult hospitalized patients who reported renal adverse reactions caused by conventional amphotericin B from January 2011 to July 2012 at pharmacovigilance center in Yonsei University Healthcare System included in this study. ADRs scored as ‘doubtful’ in Naranjo probability ADR scale were excluded. We retrospectively analyzed patients’ basic clinical characteristics, concurrent diseases or nephrotoxic drugs in order to find variables that can correlate with occurrence of renal ADRs. Changes in SCr were compared between conventional amphotericin B group and liposomal amphotericin B group. Results: A total of 231 ADRs after administration of conventional amphotericin B in 75 patients were reported to pharmacovigilance center and assessed their severities as ‘possible’, ‘probable’, or ‘definite’. Renal adverse reaction was the most common ADR with incidence rate of 42% (96of 231 ADRs). Mean change in SCr from baseline was 0.26 mg/dL (change % 37.8) and statistically significant (p=0.000). Simple correlations analysis revealed that the number of concurrent diseases and number of nephrotoxic drugs were positively correlated with changes in SCr, but these results were not statistically significant. Among 43 patients who remained amphotericin B after occurrence of renal ADRs, 27 patients was administered conventional amphotericin B and 16 patients changed to liposomal amphotericin B. Mean change in SCr in amphotericin B group was 0.23 mg/dL (32.75%), whereas mean change in SCr in liposomal amphotericin B group were -0.28 mg/dL (19.38%) and difference between two groups was statistically significant (p=0.003). The numbers of patient with SCr elevation more than 30%were 9 (33.3%) in amphotericin B group and 2 (12.5%) in liposomal amphotericin B group (Odd Ratio=3.50, 95% Confidence Interval 0.65-18.85; p=0.130). Conclusion: An analysis of ADRs due to amphotericin B administration revealed significant mean changes in SCr from baseline. Switching to liposomal amphotericin B showed significant decrease in SCr compared with conventional amphotericin B
#Conventional amphotericin B #Liposomal amphotericin B #Changes in serum creatinine

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참고문헌 (19)

참고문헌 신청
/ / Health Insurance Review and Assessment Service Website google schola Azaz-Livshits T / 1998 / Computerized surveillance of adverse drug reactions in hospital: pilot study / Br. J ClinPharmacol 45 : 309 ~ 314 google schola Bates DW / 2001 / Correlates of acute renal failure in patients receiving parenteral amphotericin B / Kidney Int 60 (4) : 1452 ~ 1459 google schola Blau IW / 2000 / Review of comparative studies between conventional and liposomal amphotericin b (Ambisome®) in neutropenic patients with fever of unknown origin and patien google schola Deray G / 2002 / Amphotericin B nephrotoxicity / Journal of Antimicrobacterial Chemotherapy 49 (suppl1) : 37 ~ 41 google schola

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