Related Experiment Video
Updated: Aug 12, 2026
06:49
Reduced Itraconazole Concentration and Durations Are Successful in Treating Batrachochytrium dendrobatidis Infection in Amphibians
Published on: March 14, 2014
Reduction of amphotericin B nephrotoxicity with mannitol
JAMA
|May 3, 1976
Summary
Adding mannitol to amphotericin B treatment may reduce kidney damage in patients with moderate renal insufficiency. This combination offers a safer, yet equally effective, candicidal therapy for fungal infections.
Area of Science:
- Mycology
- Nephrology
- Pharmacology
Background:
- Mucocutaneous candidiasis is a fungal infection requiring systemic treatment.
- Amphotericin B is a potent antifungal agent but is associated with significant nephrotoxicity.
- Renal insufficiency complicates the use of nephrotoxic drugs like amphotericin B.
Purpose of the Study:
- To evaluate the safety and efficacy of combining amphotericin B with mannitol in a patient with mucocutaneous candidiasis and renal impairment.
- To determine if mannitol co-administration mitigates amphotericin B-induced nephrotoxicity.
Main Methods:
- Case report of a patient with mucocutaneous candidiasis and moderate renal insufficiency.
- Administration of amphotericin B alone, followed by amphotericin B in combination with mannitol.
- Monitoring of renal function markers (serum creatinine, urea nitrogen).
Main Results:
- Amphotericin B monotherapy previously caused acute kidney injury.
- Concurrent administration of mannitol with amphotericin B did not exacerbate renal dysfunction.
- The combination therapy maintained antifungal efficacy.
Conclusions:
- Amphotericin B combined with mannitol presents a potentially less nephrotoxic therapeutic option for candidiasis in renally compromised patients.
- This regimen may allow for safer parenteral antifungal treatment in patients with impaired kidney function.
Related Concept Videos
01:22Drug Elimination by Renal Route: Tubular Reabsorption
During the process of renal excretion, as the glomerular filtrate progresses to the distal convoluted tubule (DCT), drugs that are highly permeable, lipophilic, and nonionized undergo passive reabsorption from the tubular fluid into the surrounding peritubular capillaries. This reabsorption process restricts their elimination through the kidneys. However, the majority of drugs are either weak acids or weak bases, and their ionization level is dependent on pH. By altering the pH of urine, the...
01:15Drug Elimination by Renal Route: Tubular Secretion
Once the process of glomerular filtration is completed, blood carrying unfiltered drug molecules traverses through efferent arterioles and makes its way into the peritubular capillaries in the proximal tubule. A variety of carriers play a pivotal role in actively secreting drugs from these peritubular capillaries into the tubular fluid. The organic anion transporter transfers acidic drugs, against an electrochemical gradient, from the peritubular capillaries into the renal tubule cells and...
01:26Enhanced Elimination of Poison
Poison can be effectively removed from the gastrointestinal (GI) tract through various decontamination procedures.
Antidotes serve a crucial role in counteracting the effects of poison by inhibiting enzymes responsible for producing harmful drug metabolites. In some cases, these toxic metabolites can be neutralized by endogenous cosubstrates, which are maintained at specific concentrations to prevent interaction with cellular macromolecules and subsequent cell death.
Renal excretion is the...
Antidotes serve a crucial role in counteracting the effects of poison by inhibiting enzymes responsible for producing harmful drug metabolites. In some cases, these toxic metabolites can be neutralized by endogenous cosubstrates, which are maintained at specific concentrations to prevent interaction with cellular macromolecules and subsequent cell death.
Renal excretion is the...
01:15Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations
Gentamicin, an aminoglycoside antibiotic, is commonly administered via intermittent intravenous infusion to treat severe infections. An intermittent one-hour infusion of gentamicin, administered at eight-hour intervals, allows for precise control of plasma drug concentrations, minimizing toxicity while ensuring therapeutic efficacy. Pharmacokinetic principles govern the dynamics of plasma concentrations and can be mathematically described using specific equations.The plasma drug concentration...
01:27Cryptococcal Meningitis
Cryptococcal meningitis is a life-threatening opportunistic infection predominantly associated with HIV/AIDS, accounting for over 100,000 deaths annually worldwide. However, it also affects individuals with other forms of immunosuppression, including those undergoing immunosuppressive therapy, organ transplant recipients, patients with innate immunodeficiencies, and individuals with hematological disorders. The infection is caused mainly by Cryptococcus neoformans and Cryptococcus gattii,...
01:15Antifungal Agents
Amphotericin B is a broad-spectrum antifungal agent that exploits structural differences between fungal and mammalian cell membranes. Its amphipathic structure—featuring a hydrophobic polyene-lactone ring and a hydrophilic region containing mycosamine and carboxylic acid groups—enables selective binding to ergosterol, a sterol predominantly found in fungal plasma membranes. This selective interaction underlies the drug’s antifungal activity, although weak binding to cholesterol contributes to...