Safe Long-Term Administration of Conventional Amphotericin B in CancerPatients

Overview

In cancer patients with persistent fever and neutropenia, amphotericin B is administered for the early treatmentand prevention of the clinically occult invasive fungal infections. The major drawback of the conventionalamphotericin B is its nephrotoxicity. We have previously showed that massive potassium, sodium, and magnesiumsupplementation, which corresponds to the amount lost in kidney during amphotericin B administration, as well asvigorous hydration, can markedly reduce nephrotoxicity of conventional amphotericin B. Clinical courses of fouroncological patients treated with conventional amphotericin B suspected or proven fungal infection for a period of24 days (two patients), 39 days, and 47 days are described. During the long-term amphotericin B administration withnephroprotective measures, no severe renal function decrease was observed in any of our patients. Massive ionsupplementation corresponding to the amounts lost in kidney, as well as the vigorous hydration are effective in theprevention of the renal function decrease induced by the long-term conventional amphotericin B therapy.

Key words:
amphotericin B, nephrotoxicity.