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

194 Scopus citations

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

ASJC Scopus subject areas

  • Immunology

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    Sharkey, P. K., Graybill, J. R., Johnson, E. S., Hausrath, S. G., Pollard, R. B., Kolokathis, A., Mildvan, D., Fan-Havard, P., Eng, R. H. K., Patterson, T. F., Pottage, J. C., Simberkoff, M. S., Wolf, J., Meyer, R. D., Gupta, R., Lee, L. W., & 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.