Liposomal Amphotericin B (AmBisome) in the Treatment of Neonatal Candidiasis in Very Low Birth Weight Infants

Infection ◽  
2000 ◽  
Vol 28 (4) ◽  
pp. 223-226 ◽  
Author(s):  
A. Juster-Reicher ◽  
E. Leibovitz ◽  
N. Linder ◽  
M. Amitay ◽  
O. Flidel-Rimon ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Amphotericin B ◽  
Liposomal Amphotericin ◽  
Very Low Birth Weight ◽  
Liposomal Amphotericin B ◽  
Low Birth Weight Infants ◽  
Neonatal Candidiasis

Which Is the Most Appropriate Dosage of Liposomal Amphotericin-B (AmBisome) for the Treatment of Fungal Infections in Infants of Very Low Birth Weight?

PEDIATRICS ◽  
1993 ◽  
Vol 91 (6) ◽  
pp. 1218-1218
Author(s):  
H. LACKNER ◽  
CH. URBAN
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Fungal Infection ◽  
Amphotericin B ◽  
Liposomal Amphotericin ◽  
Very Low Birth Weight ◽  
Fungal Infections ◽  
Liposomal Amphotericin B ◽  
Maximal Effect ◽  
Low Birth Weight Infants

In Reply.— We read with great interest the results of Pereira da Silva and co-workers, who successfully treated two premature newborns with disseminated fungal infection using lower doses of liposomal Amphotericin-B (AmBisome) than we have reported in our paper.1 We agree with the authors that the most appropriate dosage of liposomal Amphotericin-B for the treatment of very low birth weight infants is still to be established, and that the main goal of treatment should be to use AmBisome in a dose with maximal effect but minimal toxicity.

Which Is the Most Appropriate Dosage of Liposomal Amphotericin-B (AmBisome) for the Treatment of Fungal Infections in Infants of Very Low Birth Weight?

PEDIATRICS ◽  
1993 ◽  
Vol 91 (6) ◽  
pp. 1217-1218
Author(s):  
L. PEREIRA DA SILVA ◽  
J. M. VIDEIRA AMARAL ◽  
N. CORDEIRO FERREIRA
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Fungal Infection ◽  
Amphotericin B ◽  
Clinical Experience ◽  
Liposomal Amphotericin ◽  
Very Low Birth Weight ◽  
Fungal Infections ◽  
Liposomal Amphotericin B

To the Editor.— Lackner et al1 report on the excellent efficacy and lack of toxicity of 1 to 5 mg/kg per day of liposomal Amphotericin-B (AmBisome) administered to two infants of very low birth weight with disseminated fungal infection. We agree with the authors when they say that success in the treatment of two cases does not allow extrapolation of the same therapeutic schedule to an infants with identical multisystemic immaturity. We would like to report two cases from our own clinical experience with distinct characteristics.

Bladder Fungus Ball: A Reversible Cause of Neonatal Obstructive Uropathy

PEDIATRICS ◽  
1988 ◽  
Vol 81 (6) ◽  
pp. 826-829
Author(s):  
Barbara Baetz-Greenwalt ◽  
B. Debaz ◽  
Mary L. Kumar
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Amphotericin B ◽  
Very Low Birth Weight ◽  
Obstructive Uropathy ◽  
Ureteropelvic Junction ◽  
Fungus Ball ◽  
Low Birth Weight Infants ◽  
Renal Obstruction ◽  
Bladder Irrigation

Very low birth weight infants often have multiple predisposing conditions for the development of invasive candidiasis. In patients with systemic candidiasis, the kidney is vulnerable to the formation of cortical abscesses or obstructive intrarenal masses ("fungus balls"), usually at the ureteropelvic junction. Ureteropelvic junction obstructive fungal uropathy necessitates invasive debridement to restore renal function. A very low birth weight infant, infected with Candida, was first seen with hypertension, renal insufficiency, and urine cultues positive for fungus; obstructive bladder fungus ball was diagnosed by ultrasography. Mechanical disruption with amphotericin B bladder irrigation was accomplished via ultrasographic guidance, relieving renal obstruction and insufficiency. Systemic antifungal therapy was completed with amphotericin B and flucytosine. The first reported case of bladder obstructive fungal uropathy in a neonate is added to a review of 16 cases of neonatal renal obstructive uropathy.

scholarly journals A Comparison of AmBisome® to Amphotericin B for Treatment of Systemic Candidiasis in Very Low Birth Weight Infants

2007 ◽  
Vol 48 (4) ◽  
pp. 619 ◽  
Author(s):  
Ga Won Jeon ◽  
Soo Hyun Koo ◽  
Jang Hoon Lee ◽  
Jong Hee Hwang ◽  
Sung Shin Kim ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Amphotericin B ◽  
Very Low Birth Weight ◽  
Systemic Candidiasis ◽  
Low Birth Weight Infants

Disseminated Fungal Infections in Very Low-Birth-Weight Infants: Therapeutic Toxicity

PEDIATRICS ◽  
1984 ◽  
Vol 73 (2) ◽  
pp. 153-157
Author(s):  
Jill E. Baley ◽  
Robert M. Kliegman ◽  
Avroy A. Fanaroff
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Amphotericin B ◽  
Premature Infants ◽  
Antifungal Agents ◽  
Very Low Birth Weight ◽  
Fungal Infections ◽  
Invasive Procedures ◽  
Older Children ◽  
Low Birth Weight Infants

The improved survival of very low-birth-weight infants, who require prolonged hospitalization and many invasive procedures, increases the risks for nosocomial illnesses, such as disseminated fungal infections. In a 2-year period, systemic fungal infections were clinically diagnosed in ten infants. This necessitated the institution of antifungal therapy in extremely premature infants (mean birth weight 788 g, mean gestational age 28 weeks) despite the paucity of knowledge about the pharmacokinetics and toxicity of these drugs in the very immature patient. Despite the absence of reported toxicity in infants and older children, severe nephrotoxicity was commonly observed with oliguria/anuria, temporally related to the administration of amphotericin B in seven of these infants. Additional evidence of nephrotoxicity included either a rise in creatinine levels (≥1.3 mg/dL), an increase in BUN (≥30 mg/dL), hypokalemia (≤2.9 mEq/L), or hyperkalemia (≥6.0 mEq/L). Six of these seven drug-toxic infants died. Interruption of amphotericin B therapy, with reinstitution at a lower dose, was the most successful factor in alleviating the anuria. There is an urgent need for detailed pharmacokinetic and toxicity studies of antifungal agents in immature infants.

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