Ellis M, Bernsen R, Ali-Zadeh H et al.
J Medical Microbiol 2009;58:1474–85.
In this study, a high intermittent dose regimen of liposomal amphotericin B (10 mg/kg on day 1 followed by 5 mg/kg on days 3 and 6) was compared with a standard daily dosing regimen (3 mg/kg/day for 14 days) for empirical treatment of persistent febrile neutropenia. No difference in a composite outcome was noted among the patients treated with the high intermittent dosing regimen compared with the patients treated with the standard regimen. Both regimens had similar safety profiles and no patient in either group discontinued study medication secondary to toxicity.
Liposomal amphotericin B (L-AmB) is commonly used at a dose of 3 mg/kg/day for the empirical treatment of patients with persistent febrile neutropenia. Owing to the pharmacokinetic and pharmacodynamic properties of amphotericin B, higher doses may increase the amount of drug deposited in tissues and therefore increase antifungal activity. To test the clinical significance of these properties, this study was undertaken to compare the clinical safety and composite efficacy of a high, intermittent dose regimen of L-AmB (10 mg/kg on day 1
followed by 5 mg/kg on days 3 and 6) with a standard, daily dosing regimen (3 mg/kg/day for 14 days) for empirical treatment of persistent febrile neutropenia.