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[Ambulatory therapy with amphotericin B]
C Berger1, A Gratwohl, A Tichelli
1Departement Innere Medizin, Kantonsspital Basel.
Abstract:
Therapy of systemic fungal infection with amphotericin B (AmB) must be continued for several months and is usually performed on an inpatient basis because of the risk of drug toxicity. Between 1983 and 1987 we treated 14 outpatients with a total of 164 AmB infusions. Side effects were generally mild and easy to control. Progressive impairment of renal function led to dose reduction and interruption of therapy in only one patient. Ambulatory therapy with AmB is feasible in an outpatient unit with adequate experience, and a significant reduction of treatment costs can result. Outpatient therapy is an acceptable alternative to inpatient treatment. Patients with malignant diseases under palliative therapy will profit most from the reduced duration of hospital stay.
Insights
Outpatient treatment with amphotericin B (AmB) for systemic fungal infections is feasible and cost-effective. This approach minimizes drug toxicity risks and hospital stays, offering an acceptable alternative to inpatient care.
Area of Science:
- Mycology
- Pharmacology
- Infectious Diseases
Context:
- Systemic fungal infections require prolonged amphotericin B (AmB) therapy, typically inpatient due to toxicity concerns.
- Traditional AmB treatment necessitates lengthy hospitalizations, increasing healthcare costs and patient burden.
- Managing AmB toxicity, particularly renal impairment, is crucial for treatment continuation.
Purpose:
- To evaluate the feasibility and safety of outpatient amphotericin B (AmB) therapy for systemic fungal infections.
- To assess the side effect profile and renal function impact during ambulatory AmB treatment.
- To determine the potential for cost reduction and patient benefit through outpatient AmB administration.
Summary:
- A study treated 14 outpatients with 164 amphotericin B (AmB) infusions between 1983 and 1987.
- Side effects were generally mild and manageable, with only one patient experiencing dose reduction due to renal impairment.
- Outpatient AmB therapy proved feasible in an experienced unit, demonstrating potential for significant cost savings.
Impact:
- Outpatient amphotericin B (AmB) therapy is a viable and cost-effective alternative to inpatient treatment.
- This approach can reduce treatment costs and shorten hospital stays, benefiting patients, especially those with malignant diseases.
- Successful ambulatory AmB administration highlights the potential for decentralized, patient-centered care in managing systemic fungal infections.