Citas bibligráficas
Espinoza, C., (2014). Análisis comparativo de seguridad entre anfotericina B convencional y anfotericina B complejo lipídico en pacientes del Hospital Nacional Edgardo Rebagliati Martins en el período 2011-2012 [Tesis, Universidad Nacional Mayor de San Marcos]. https://hdl.handle.net/20.500.12672/3482
Espinoza, C., Análisis comparativo de seguridad entre anfotericina B convencional y anfotericina B complejo lipídico en pacientes del Hospital Nacional Edgardo Rebagliati Martins en el período 2011-2012 [Tesis]. PE: Universidad Nacional Mayor de San Marcos; 2014. https://hdl.handle.net/20.500.12672/3482
@misc{renati/324448,
title = "Análisis comparativo de seguridad entre anfotericina B convencional y anfotericina B complejo lipídico en pacientes del Hospital Nacional Edgardo Rebagliati Martins en el período 2011-2012",
author = "Espinoza Cobeñas, Carlos Augusto",
publisher = "Universidad Nacional Mayor de San Marcos",
year = "2014"
}
Objective: To compare the safety profiles of amphotericin B lipid complex and conventional amphotericin B. Methods: It was analyzed the medical records of all patients of “Edgardo Rebagliati Martins“ National Hospital who received amphotericin B, both confirmed fungal infections and empirical therapy of suspected fungal infection or as antileishmanial drug during the period from 1 August 2011 until 31 July 2012. 76 patients met inclusion and exclusion criteria. It was evaluated the administered dose, laboratory tests of each patient before, during and after treatment with those recorded observations by the attending physician and nursing notes. Results: No statistically significant differences were found in the clinical effectiveness of amphotericin B deoxycholate (48.5%) - AmB - and amphotericin B lipid complex (60 %) - ABCL -(p - value 0.421), no differences were found in the clinical efficacy (50.0 % vs 66.7 % for AmB for ABCL, p- value 0.348). Of intrinsic drug reactions, statistically significant differences at the level of renal profile was found in the serum creatinine increase both in the presence (79.7% vs 50 % for AmB for ABCL, OR 0.25 95% CI [0.087 to 0.74] , p- value 0.009) and more likely to increase at least 20% (p- value 0.03 ), but no significant differences were found in the presence of acute renal injury (40.6 % for AmB and 30% for ABCL, p- value 0.393). 9.6% of patients using AmB had renal failure (kidney injury stage 3 / RIFLE -F). No significant differences at the level of haematological and liver function were found. According to CIOMS modified criteria, the presence of hepatotoxicity was 21.7% and 37.5% for AmB for ABCL (p- value 0.60). Concerning infusion reactions, there was significant differences in the presence of nausea (25.0% vs 56.5 % for AmB for ABCL, p- value 0.006), fever (28.1% were found for AmB vs 52.2 % for ABCL, p- value 0.037), and chills (3.1% for AmB vs. 30.4 % ABCL, p- value 0.001), however no significant differences were found in the presence of vomiting, malaise, hypertension and phlebitis. Conclusions: Amphotericin B lipid complex shows efficacy and effectiveness comparable to that of amphotericin B deoxycholate. Statistically significant differences in the increase of creatinine in favor of amphotericin B lipid complex were found. Keywords: Amphotericin B deoxycholate, amphotericin B lipid complex, acute renal injury, hepatotoxicity, adverse reactions.
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