SAFETY AND EFFICACY OF INTRALIPID EMULSIONS OF AMPHOTERICIN-B

To evaluate the clinical role of amphotericin/20% Intralipid emulsions (ILA), we conducted a Medline search of the English literature to loc ate the relevant case reports and clinical studies involving the use o f this formulation. Due to differences in study design and definitions , we applied a set of treatment outcome definitions to determine the c linical efficacy of this treatment modality. Only 37 patients received ILA for the treatment of documented fungal infections. Using our defi nitions, four were considered successfully treated, one improved, two failed, and 30 were unevaluable. While infusion-related adverse events and nephrotoxicity were reportedly reduced with ILA, use of adjunctiv e therapies and concomitant nephrotoxic agents, and comparisons with h igh infusion concentrations complicate evaluation. Furthermore, incomp lete and conflicting data exist regarding the physiochemical stability of ILA. The currently available data do not support recommendations f or the use of this formulation for the treatment of systemic fungal in fections.