Triad of acute infusion-related reactions associated with liposomal amphotericin B: analysis of clinical and epidemiological characteristics

Clin Infect Dis. 2003 May 15;36(10):1213-20. doi: 10.1086/374553. Epub 2003 May 8.

Abstract

We investigated the clinical characteristics and treatment of patients with a distinctive triad of acute infusion-related reactions (AIRRs) to liposomal amphotericin B (L-AMB) via single-center and multicenter analyses. AIRRs occurred alone or in combination within 1 of 3 symptom complexes: (1) chest pain, dyspnea, and hypoxia; (2) severe abdomen, flank, or leg pain; and (3) flushing and urticaria. The frequency of AIRRs in the single-center analysis increased over time. Most AIRRs (86%) occurred within the first 5 min of infusion. All patients experienced rapid resolution of symptoms after intravenous diphenhydramine was administered. The multicenter analysis demonstrated a mean overall frequency of 20% (range, 0%-100%) of AIRRs among 64 centers. A triad of severe AIRRs to L-AMB may occur in some centers; most of these reactions may be effectively managed by diphenhydramine administration and interruption of L-AMB infusion.

Publication types

  • Multicenter Study

MeSH terms

  • Abdominal Pain / etiology
  • Adult
  • Amphotericin B / administration & dosage
  • Amphotericin B / adverse effects*
  • Antifungal Agents / administration & dosage
  • Antifungal Agents / adverse effects*
  • Chest Pain / etiology
  • Drug Combinations
  • Dyspnea / etiology
  • Female
  • Flushing / etiology
  • Humans
  • Hypoxia / etiology
  • Liposomes
  • Male
  • Phosphatidylcholines / adverse effects
  • Phosphatidylglycerols / adverse effects
  • Risk Factors

Substances

  • Antifungal Agents
  • Drug Combinations
  • Liposomes
  • Phosphatidylcholines
  • Phosphatidylglycerols
  • liposomal amphotericin B
  • Amphotericin B