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Ventajas y desventajas de los distintos tipos de anfotericina en pediatría: revisión de la bibliografía

DOI: 10.5546/aap.2012.46

Keywords: amphotericin, side effects, toxicity, children, pharmacoeconomics, kidney.

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Abstract:

fungal infections have increased in morbidity, and the range of fungal species causing disease in humans has expanded, mainly due to the rise in number of immunocompromised patients. am-photericin b is a broad spectrum antifungal agent that has been the standard therapy for many life-threatening mycoses for the past 50 years. however, the use of this drug is commonly associated with infusion related events (such as chills, fever, headache, nausea, vomiting), and most signif-cantly to dose limiting nephrotoxicity. three lipid formulations that increase the therapeutic index have been approved for use. however, questions regarding dose, cost-effectiveness and indications exist in the pediatric setting. although no high quality evidence studies in children comparing the four types of amphotericin in culture-positive fungal infections currently exist, all four preparations are believed to have similar effectiveness. high drug costs limit the use of lipid formulations; however, renal toxic side effects should be taken into account when costs are considered.

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