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Archivos argentinos de pediatría
Print version ISSN 0325-0075
Abstract
BES, David F; SBERNA, Norma and ROSANOVA, María Teresa. Advantages and drawbacks of amphotericin formulations in children: literature review. Arch. argent. pediatr. [online]. 2012, vol.110, n.1, pp.46-51. ISSN 0325-0075. http://dx.doi.org/10.5546/aap.2012.46.
Fungal infections have increased in morbidity, and the range of fungal species causing disease in humans has expanded, mainly due to the rise in number of immunocompromised patients. Am-photericin B is a broad spectrum antifungal agent that has been the standard therapy for many life-threatening mycoses for the past 50 years. However, the use of this drug is commonly associated with infusion related events (such as chills, fever, headache, nausea, vomiting), and most signif-cantly to dose limiting nephrotoxicity. Three lipid formulations that increase the therapeutic index have been approved for use. However, questions regarding dose, cost-effectiveness and indications exist in the pediatric setting. Although no high quality evidence studies in children comparing the four types of amphotericin in culture-positive fungal infections currently exist, all four preparations are believed to have similar effectiveness. High drug costs limit the use of lipid formulations; however, renal toxic side effects should be taken into account when costs are considered.
Keywords : Amphotericin; Side effects; Toxicity; Children; Pharmacoeconomics; Kidney.