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Amphotericin B remains a cornerstone of treatment for serious fungal infections, despite its association with nephrotoxicity. Current recommendations suggest infusing the drug over 2 to 6 hours to diminish this toxicity; using liposome formulations of amphotericin B also reduces toxicity. The reasons for the toxicity reductions are unknown but may be related to slower drug delivery to tissues.
Swiss investigators randomized 80 patients (most neutropenic) with refractory fever or suspected or proven deep fungal infections to receive amphotericin B either by continuous infusion over 24 hours or by rapid infusion over 4 hours; 39 and 31 patients, respectively, completed treatment. Follow-up was 3 months.
Side effects occurred mainly during the f…