Amphotericin B lipid complex compared with amphotericin B in the treatment of cryptococcal meningitis in patients with AIDS

Patricia K. Sharkey, John R. Graybill, Edward S. Johnson, Stephen G. Hausrath, Richard B Pollard, Antonia Kolokathis, Donna Mildvan, Patty Fan-Havard, Robert H K Eng, Thomas F. Patterson, John C. Pottage, Michael S. Simberkoff, Judith Wolf, Richard D. Meyer, Renu Gupta, Lily W. Lee, David S. Gordon

Research output: Contribution to journalArticle

193 Citations (Scopus)

Abstract

The study objective was to obtain preliminary information regarding the safety and efficacy of amphotericin B (AraB) lipid complex (ABLC) in the treatment of AIDS-associated cryptococcal meningitis. Of 55 patients randomly assigned to 6 weeks of therapy with ABLC (1.2-5.0 mg/[kg-d], with ascending doses for three sequential cohorts) or Amb (0.7-1.2 mg/[kg-d]), 46 received ≥ 12 doses. Transfusion requirements, mean decreases in hemoglobin level, and mean increases in creatinine level were significantly greater with Arab than with ABLC. The total number of adverse events, infusion-related events, and occurrences of hypomagnesemia and hypokalemia associated with each form of therapy were similar. Among 21 recipients of ABLC at a dosage of 5 mg/kg (daily for 2 weeks and then thrice weekly for 4 weeks), symptoms and signs resolved for 18 (86%). Of those receiving ≥ 12 doses of ABLC, cultures converted to negative for 8 (42%), were undeterminable for 3 (16%), and remained positive for 8 (42%) despite resolution of symptoms. Although preliminary, these data suggest ABLC has significant activity in patients with AIDS-associated cryptococcal meningitis. Because this formulation has less hematologic and renal toxicity than does AraB, further evaluation of ABLC is warranted.

Original languageEnglish (US)
Pages (from-to)315-321
Number of pages7
JournalClinical Infectious Diseases
Volume22
Issue number2
StatePublished - Feb 1996
Externally publishedYes

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Cryptococcal Meningitis
Amphotericin B
Acquired Immunodeficiency Syndrome
Lipids
Therapeutics
Hypokalemia
liposomal amphotericin B
Signs and Symptoms
Creatinine
Hemoglobins
Kidney
Safety

ASJC Scopus subject areas

  • Immunology

Cite this

Sharkey, P. K., Graybill, J. R., Johnson, E. S., Hausrath, S. G., Pollard, R. B., Kolokathis, A., ... Gordon, D. S. (1996). Amphotericin B lipid complex compared with amphotericin B in the treatment of cryptococcal meningitis in patients with AIDS. Clinical Infectious Diseases, 22(2), 315-321.

Amphotericin B lipid complex compared with amphotericin B in the treatment of cryptococcal meningitis in patients with AIDS. / Sharkey, Patricia K.; Graybill, John R.; Johnson, Edward S.; Hausrath, Stephen G.; Pollard, Richard B; Kolokathis, Antonia; Mildvan, Donna; Fan-Havard, Patty; Eng, Robert H K; Patterson, Thomas F.; Pottage, John C.; Simberkoff, Michael S.; Wolf, Judith; Meyer, Richard D.; Gupta, Renu; Lee, Lily W.; Gordon, David S.

In: Clinical Infectious Diseases, Vol. 22, No. 2, 02.1996, p. 315-321.

Research output: Contribution to journalArticle

Sharkey, PK, Graybill, JR, Johnson, ES, Hausrath, SG, Pollard, RB, Kolokathis, A, Mildvan, D, Fan-Havard, P, Eng, RHK, Patterson, TF, Pottage, JC, Simberkoff, MS, Wolf, J, Meyer, RD, Gupta, R, Lee, LW & Gordon, DS 1996, 'Amphotericin B lipid complex compared with amphotericin B in the treatment of cryptococcal meningitis in patients with AIDS', Clinical Infectious Diseases, vol. 22, no. 2, pp. 315-321.
Sharkey, Patricia K. ; Graybill, John R. ; Johnson, Edward S. ; Hausrath, Stephen G. ; Pollard, Richard B ; Kolokathis, Antonia ; Mildvan, Donna ; Fan-Havard, Patty ; Eng, Robert H K ; Patterson, Thomas F. ; Pottage, John C. ; Simberkoff, Michael S. ; Wolf, Judith ; Meyer, Richard D. ; Gupta, Renu ; Lee, Lily W. ; Gordon, David S. / Amphotericin B lipid complex compared with amphotericin B in the treatment of cryptococcal meningitis in patients with AIDS. In: Clinical Infectious Diseases. 1996 ; Vol. 22, No. 2. pp. 315-321.
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