Liposomal Amphotericin-B (AmBisome) for Treatment of Disseminated Fungal Infections in Two Infants of Very Low Birth Weight

Systemic fungal infections represent an increasing problem among low birth weight neonates.1-4 The necessity of many invasive procedures such as endotracheal intubation, central venous catheterization, prolonged antibiotic therapy, and hyperalimentation including intravenous fat emulsions increases the risk of nosocomial infections.4,5 Amphotericin-B (Amph-B) combined with 5-fluorocytosine is reported to be the treatment of choice for disseminated fungal infections. However conventional Amph-B medication is often limited due to severe side effects. Fever, chills, bronchospastic reactions, nephrotoxicity, and hepatic necrosis have been reported frequently.2,6 Previous experiences with immunocompromised patients indicate that the liposomal encapsulation of amphotericin-B decreases its toxicity while maintaining its effectiveness as an antifungal agent.7-12