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Liposomal amphotericin B does not induce nephrotoxicity or renal function impairment in premature neonates

P Manzoni1, P Galletto, S Rizzollo

  • 1Neonatology and NICU, Sant'Anna Hospital, Azienda Ospedaliera OIRM - S Anna, Torino, Italy. paolomanzoni@hotmail.com

Early Human Development
|May 29, 2012
PubMed
Abstract

Insights

Liposomal amphotericin B (LAMB) is safe for very low birth weight (VLBW) infants. Renal toxicity from LAMB is uncommon, mild, and transient in VLBW neonates treated for fungal infections.

Area of Science:

  • Neonatal medicine
  • Pediatric pharmacology
  • Infectious diseases

Background:

  • Liposomal amphotericin B (LAMB) is a common treatment for systemic fungal infections (SFI) in very low birth weight (VLBW) preterm infants.
  • Concerns exist regarding LAMB's safety and tolerability in VLBW neonates due to their predisposition to renal function impairment.

Purpose of the Study:

  • To assess the incidence of renal function impairment associated with LAMB treatment in a decade-long cohort of VLBW neonates.
  • To evaluate the safety and tolerability profile of LAMB in this vulnerable population.

Main Methods:

  • A retrospective analysis of clinical charts was conducted for VLBW neonates treated with LAMB between 1998 and 2007.
  • The study identified neonates who received LAMB, investigated LAMB-attributable renal toxicity, and identified infants withdrawn due to adverse effects.

Main Results:

  • Of 792 VLBW neonates, 71 (8.9%) received LAMB at recommended dosages for a mean of 14 days.
  • Renal compromise (hypokalemia, elevated creatinine, or decreased urine output) occurred in 2 of 71 (2.8%) neonates, appearing around day 5 of treatment.
  • The renal impairment was mild, transient, and resolved before discharge; no other significant adverse effects were noted.

Conclusions:

  • Liposomal amphotericin B (LAMB) demonstrates a favorable safety and tolerability profile in very low birth weight (VLBW) neonates.
  • LAMB-related nephrotoxicity is infrequent and typically mild and transient in VLBW infants.
  • LAMB can be safely administered to VLBW neonates for systemic fungal infections.

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