Comparison of effects of amphotericin B deoxycholate infused over 4 or 24 hours: randomised controlled trial

BMJ. 2001 Mar 10;322(7286):579-82. doi: 10.1136/bmj.322.7286.579.


Objective: To test the hypothesis that amphotericin B deoxycholate is less toxic when given by continuous infusion than by conventional rapid infusion.

Design: Randomised, controlled, non-blinded, single centre study.

Setting: University hospital providing tertiary clinical care.

Patients: 80 mostly neutropenic patients with refractory fever and suspected or proved invasive fungal infections.

Intervention: Patients were randomised to receive 0.97 mg/kg amphotericin B by continuous infusion over 24 hours or 0.95 mg/kg by rapid infusion over four hours.

Main outcome measures: Patients were evaluated for side effects related to infusion, nephrotoxicity, and mortality up to three months after treatment. Analysis was on an intention to treat basis.

Results: Patients in the continuous infusion group had fewer side effects and significantly reduced nephrotoxicity than those in the rapid infusion group. Overall mortality was higher during treatment and after three months' follow up in the rapid infusion than in the continuous infusion group.

Conclusion: Continuous infusions of amphotericin B reduce nephrotoxicity and side effects related to infusion without increasing mortality.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Amphotericin B / administration & dosage*
  • Amphotericin B / adverse effects
  • Antifungal Agents / administration & dosage*
  • Antifungal Agents / adverse effects
  • Deoxycholic Acid / administration & dosage*
  • Deoxycholic Acid / adverse effects
  • Drug Administration Schedule
  • Drug Combinations
  • Female
  • Follow-Up Studies
  • Humans
  • Kidney Diseases / chemically induced
  • Male
  • Middle Aged
  • Mycoses / complications
  • Mycoses / drug therapy*
  • Neutropenia / complications
  • Opportunistic Infections / complications
  • Opportunistic Infections / drug therapy*
  • Prospective Studies
  • Survival Rate


  • Antifungal Agents
  • Drug Combinations
  • Deoxycholic Acid
  • Amphotericin B
  • amphotericin B, deoxycholate drug combination