continuous versus conventional infusion of amphotericin B deoxycholate: a meta-analysis

Area of Science:

• Infectious Diseases
• Nephrology
• Pharmacology

Background:

• Amphotericin B (AmB) deoxycholate is widely used, especially in low-resource settings.
• Nephrotoxicity is a significant challenge associated with AmB deoxycholate treatment.
• Investigating alternative administration methods to mitigate side effects is crucial.

Purpose of the Study:

• To evaluate if continuous infusion of AmB deoxycholate reduces nephrotoxicity compared to conventional infusion.
• To assess the effectiveness of continuous AmB infusion regarding patient survival and treatment failure.

Main Methods:

• Systematic literature search of PubMed and Scopus databases.
• Inclusion of studies comparing 24-h AmB infusion (continuous) versus 2-6-h infusion (conventional).
• Primary outcomes: nephrotoxicity and all-cause mortality; Secondary outcome: treatment failure.

Main Results:

• Five studies (392 patients) analyzed nephrotoxicity data.
• A non-significant trend towards lower nephrotoxicity with continuous AmB infusion (RR=0.61).
• No significant difference in all-cause mortality between infusion methods (RR=0.81); treatment failure data was insufficient.

Conclusions:

• Continuous AmB deoxycholate infusion may reduce nephrotoxicity compared to conventional methods.
• The current evidence suggests no compromise in patient survival with continuous infusion.
• Further randomized controlled trials are necessary to confirm these findings.