Amphotericin B


Liposomal preparations of amphotericin B have the advantage of lower toxicity compared with conventional preparations.
 
Ambisome has proved effective in the treatment of fungal infections including candida, aspergillus and cryptococcus.
 
Incidence
3/187 in transplant recipients.
 
One case of fatal cardiac arrest.
 
Risk factors
AIDS.
 
Clinical manifestations
Anaphylactic shock, fever.
 
Bronchospasm.
 
Rash, erythema, edema.
 
Diagnostic methods
None.
 
Mechanisms
Unknown.
 
The lipid content of the drug is suspected to be the culprit.
 
Management
Anaphylaxis to ambisome does not preclude subsequent use of amphotericin B, which is well tolerated.

References

  1. Torre I, Lopez-Herce J, Vazquez P, "Anaphylactic reaction to liposomal amphotericin B in children (letter)", Ann. Pharmacother., 1996 ; 30 (9): 1036-7
  2. Ringden O, Andström E, Remberger M, Svahn B.M, Tollemar J, "Allergic reactions and other rare side effects of liposomal amphotericin", Lancet, 1994 ; 344 (8930): 1156-7
  3. Laing R.D.S, Milne L.J.R, Leen C.L.S, Malcolm G.P, Steers A.J.W, "Anaphylactic reactions to liposomal amphotericin", Lancet. , 1994 ; 344 (8923): 682
  4. Tollemar J, Ringden O, Andersson S, Sundberg B, Ljungman P, Tyden G, "A randomized double-blind study of AmBisome (liposomal amphotericin B) in prophylaxis of invasive fungal infections in bone marrow transplant recipients", Bone Marrow Transplant., 1993 ; 12: 577-81

As in all diagnostic testing, the diagnosis is made by the physican based on both test results and the patient history.