Safety and tolerability of Amphotericin B Lipid Complex (Abelcet)

Purpose To assess the safety and tolerability of Amphotericin B Lipid Compl ex (Ablecet) in children. Patients and Methods All patients had malignant disease and required amphot ericin for fever refractory to standard antibiotic therapy. Consecutive coh orts received Abelcet 5mg/kg/day (Group 1; n = 26 episodes) or 2.5 mg/kg/da y (Group 2; n = 29 episodes). Results Baseline demographic characteristics and use of other nephrotoxic a gents did not differ between the two groups. Infusion-related toxicity occu rred despite premedication in 24% episodes in Group 1 and 28% episodes in G roup 2. Doubling of serum creatinine from baseline was seen in 27% and 15% of episodes in Groups 1 and 2, respectively. Hypokalaemia (<2.5mmol/l) was seen at similar frequency in both groups (Group 1, 31%, Group 2, 35%) but t otal potassium supplementation was significantly greater on 5mg/kg/day Abel cet. Most toxicity was self-limiting. Conclusions Both doses of Abelcet were associated with amphotericin-related toxicity in this high risk patient population but 2.5 mg/kg/day caused les s potassium wasting and may have been less nephrotoxic than 5 mg/kg/day.