Case-control study of amphotericin B in a triglyceride fat emulsion versus conventional amphotericin B in patients...

We evaluated the efficacy and tolerability of amphotericin B triglyceride emulsion in 16 patients with acquired immunodeficiency syndrome-related candidal esophagitis and cryptococcosis, compared with standard amphotericin B in 24 patients. Compared with the conventional formulation, the fat emulsion was administered in a significantly greater daily dose, and required shorter induction period and infusion time (p<0.001-<0.03). Although the two drugs had similar clinical and microbiologic efficacy, the fat emulsion had a better safety profile with respect to frequency of flu-like symptoms, other local and systemic adverse events, and treatment discontinuation (p<0.02-<0.05). Because it is easily available and inexpensive, it may have a number of advantages over the conventional formulation. Further similar comparisons are warranted, in addition to investigations to assess whether reduced toxicity can be obtained with fat emulsion without impairing (or possibly improving) the efficacy of this key antifungal agent.