Nghiên cứu thuần tập về độ an toàn của amphotericin B deoxycholate và các biện pháp dự phòng biến cố bất lợi tại Bệnh viện Phổi Trung ương

Abstract

Objective: To evaluate adverse events (AEs) of amphotericin B deoxycholate (AmB-d) in the treatment of invasive fungal infections. We also assess the role of loading sodium chloride 0.9% in reduction of AmB-d induced nephrotoxic and the use of pretreatment regimens for the prophylaxis of infusion-related reactions. Subject and method: This retrospective study in inpatients treated with AmB-d at the National Lung Hospital between 01/1/2018 and 31/8/2020. Result: Out of 119 patients, the proportion of patients experiencing AEs related to clinical symptoms and laboratory tests were 24% and 90%, respectively. The number of patients who had the infusion-related reaction, hypokalemia, nephrotoxicity were 23 (19%), 79 (66%), and 48 (40%), respectively. The treatment of saline 0.9% associated with the reduction of 5.24µmol of serum creatinine (beta= -5.24µmol; 95% CI: -9.29 - -1.19, p=0.011), while the use of pretreatment regimens associated with the reduction of infusion-related reaction (OR = 0.08, 95%CI: 0.03 - 0.28, p<0.001). Conclusion: It is important to monitor AEs during the treatment of AmB-d. Preliminary assessment the use of saline 0.9% and pretreatment regimens could reduce AmB-d induced nephrotoxicity and infusion-related reactions.