Ed. Ralph et al., CLINICAL-EXPERIENCE WITH MULTILAMELLAR LIPOSOMAL AMPHOTERICIN-B IN PATIENTS WITH PROVEN AND SUSPECTED FUNGAL-INFECTIONS, Scandinavian journal of infectious diseases, 25(4), 1993, pp. 487-496
Over a 3-year period, an unsonicated multilamellar vesicle preparation
containing a low ratio of amphotericin B (5 mole %) was used as a rou
tine alternative to amphotericin B-deoxycholate in treating 17 patient
s with a variety of systemic fungal infections representative of those
commonly encountered on a tertiary care centre infectious disease ser
vice. Patient acceptability and convenience of administration were not
eworthy. In 6/7 patients who had been given the liposomal drug after e
xperiencing severe side effects (primarily hypokalemia and marked elev
ation of serum creatinine) on the non-liposomal form, the problems tha
t had led to institution of the liposomal drug were reversed during tr
eatment. However, multilamellar liposomal amphotericin B at convention
al dosage was not without detectable toxicity in this patient populati
on. Three transplant patients receiving cyclosporin at the same time a
s liposomal amphotericin B experienced a rise in serum creatinine, and
4 patients became hypokalemic during treatment: none of these effects
was severe or required discontinuation of therapy. One or more liver
enzymes rose measurably in 7 patients during treatment with liposomal
amphotericin B, but remained unchanged or actually decreased in the re
maining patients.