Amphotericin-Associated Infusion-Related Reactions: A Narrative Review of Pre-Medications |
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| Institution: | 1. Department of Pharmacy, Ann & Robert H. Lurie Children''s Hospital, Chicago, Illinois;2. Lurie Children''s Pediatric Research & Evidence Synthesis Center (PRECIISE; A JBI Affiliated Group), Chicago, Illinois;3. Department of Clinical and Organizational Development, Ann & Robert H. Lurie Children''s Hospital, Chicago, Illinois;4. Northwestern University Feinberg School of Medicine, Chicago, Illinois;1. Division of Pediatric Infectious Diseases, Ann & Robert H. Lurie Children''s Hospital of Chicago;2. Northwestern University Feinberg School of Medicine, Chicago, Illinois;1. Clinical Medical College, Yangzhou University, Yangzhou, China;2. Department of Pharmaceutics, University of Florida, Gainesville, Florida;3. College of Pharmacy, Dalian Medical University, Dalian, China;4. Faculty of Medicine and Surgery, Vita Salute San Raffaele University, Milan, Italy;5. Department of Biostatistics, University of Florida, Gainesville, Florida |
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| Abstract: | PurposeAmphotericin B has been reported to cause infusion-related adverse effects (IRAEs). To prevent IRAEs, pre-medications may be administered prior to the administration of amphotericin B. The effects of different formulations of amphotericin B (amphotericin B deoxycholate and lipid formulations), duration of infusion, and utility of pre-medications in preventing IRAEs are reviewed.MethodsPubMed, Ovid Medline, Embase, Web of Science, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and the Scopus databases were searched with the following search terms: pre-medication, amphotericin B, and its related compounds. Upon review, a total of 39 publications were considered for inclusion.FindingsIn vitro and in vivo studies have reported that amphotericin B deoxycholate stimulates pro-inflammatory cytokine genes causing IRAEs. Nonetheless, the clinical literature has reported that IRAEs occur among patients who received pre-medications. In comparison to amphotericin B deoxycholate, lipid-based formulations of amphotericin may result in a lower or similar risk for IRAEs.ImplicationsThe routine use of pre-medications to prevent IRAEs after the administration of amphotericin B (amphotericin B deoxycholate or lipid formulations) would not be warranted. |
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