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The following message was posted to: PharmPK
Hi All,
We are interested in administering amphotericin B deoxycholate as a
continuous infusion as described by Eriksson et al (BMJ 322, 10 March
2001).
A continuous infusion was shown to be better tolerated by patients and
at
least as effective as infusion over 4 hours. The paper did not provide
enough subjects to assess efficacy.
On theoretical grounds I would like to know if the PK/PD of amphotericin
favors this method of administration. Does amphotericin exhibit a
concentration or time dependent antifungal action? Does it show a
post-antifungal effect? Since an important component of its mechanism of
action involves cell wall binding with alterations in membrane
permeability
leading to cell death, I think it would show time dependent killing -
this
would support its use as a continuous infusion.
Thanks for any help,
Bob Gillies BSc(Pharm), PharmD
Clinical Pharmacy Specialist
Surrey Memorial Hospital
Surrey, B.C.
604-585-5666 Local 8397
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The following message was posted to: PharmPK
HI!
Dave Andes published in Antimicrobial Agents and Chemotherapy a year or
two ago that Amphotericin B is actually Peak/MIC driven. Yes, it has a
prolonged persistent effect (in vivo, the sum of the PAE and PASME).
Hope this helps,
George Drusano
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The following message was posted to: PharmPK
George,
I take it that PAE = post-antibiotic effect but what is PASME?
Dave Benziger
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Post Antibiotic Sub-MIC Effect
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