{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T19:54:09Z","timestamp":1781034849598,"version":"3.54.1"},"reference-count":24,"publisher":"BMJ","issue":"6859","license":[{"start":{"date-parts":[[1992,10,17]],"date-time":"1992-10-17T00:00:00Z","timestamp":719280000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ"],"published-print":{"date-parts":[[1992,10,17]]},"abstract":"<jats:p>OBJECTIVES--To compare the tolerance, efficacy, and pharmacokinetics of amphotericin deoxycholate (Fungizone) prepared in a parenteral fat emulsion (Intralipid 20%) or glucose in HIV patients with candidiasis. DESIGN--Non-blind randomised controlled trial. SETTING--University hospital; tertiary clinical care. PATIENTS--22 HIV positive patients with oral candidiasis. INTERVENTIONS--Amphotericin 1 mg\/kg\/day given on four consecutive days as a one hour infusion dissolved in either 5% glucose (amphotericin-glucose) or parenteral fat emulsion at a final concentration of 2 g\/l fat emulsion (amphotericin-fat emulsion). MAIN OUTCOME MEASURES--Clinical tolerance (fever, chills, sweats, nausea, arterial pressure, and pulse rate); biological tolerance (serum creatinine, electrolyte, and magnesium values); clinical score of candidiasis; and serum concentrations of amphotericin. RESULTS--11 patients were enrolled in each group. All the amphotericin-fat emulsion infusions were given without serious problem whereas four amphotericin-glucose infusions were stopped because of renal impairment (n = 3) or severe chills (n = 2), or both. For patients completing the amphotericin-glucose treatment creatine concentration increased by 42 mumol\/l; four of seven patients had at least one creatinine value &gt; or = 133 mumol\/l versus one of 11 receiving amphotericin-fat emulsion. Magnesium concentration fell significantly with amphotericin-glucose but not with amphotericin-fat emulsion. Clinical side effects were noted in 36\/38 infusions with amphotericin-glucose but 10\/44 with amphotericin-fat emulsion. Oral candidiasis score was reduced similarly in both groups. Serum amphotericin concentrations were significantly lower and the volume of distribution of the drug higher after infusion of amphotericin-fat emulsion than after amphotericin-glucose. CONCLUSIONS--Clinical and renal toxicity of amphotericin are reduced when the drug is prepared in fat emulsion. Preparation is simple and cost effective. Its efficacy is similar to that of conventional amphotericin.<\/jats:p>","DOI":"10.1136\/bmj.305.6859.921","type":"journal-article","created":{"date-parts":[[2009,3,30]],"date-time":"2009-03-30T08:16:37Z","timestamp":1238400997000},"page":"921-925","source":"Crossref","is-referenced-by-count":82,"title":["Trial of glucose versus fat emulsion in preparation of amphotericin for use in HIV infected patients with candidiasis."],"prefix":"10.1136","volume":"305","author":[{"given":"P. Y.","family":"Chavanet","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Garry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Charlier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Caillot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. P.","family":"Kisterman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"D'Athis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Portier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1992,10,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1093\/clinids\/12.2.308","article-title":"Amphotericin B: 30 years of clinical experience","volume":"12","author":"Gallis, H.; Drew, R.; Pickard, W.","year":"1990","unstructured":"Gallis H, Drew R, Pickard W. Amphotericin B: 30 years of clinical experience. Rev Infect Dis 1990;12:308-28.","journal-title":"Rev Infect Dis"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1097\/00002030-199105000-00007","article-title":"The prevalence of oral lesions in HIV-infected homosexual and bisexual men: three San Francisco epidemiological cohorts","volume":"5","author":"Feigal, F.; Katz, M.; Greenspan, D.; Wetenhouse, J.; Winkelstein, W.; Lang, W.","year":"1991","unstructured":"Feigal F, Katz M, Greenspan D, Wetenhouse J, Winkelstein W, Lang W, et al. The prevalence of oral lesions in HIV-infected homosexual and bisexual men: three San Francisco epidemiological cohorts. AIDS 1991;5: 519-25.","journal-title":"AIDS"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1093\/clinids\/13.3.480","article-title":"The growing problem of mycoses in patients infected with the human immunodeficiency virus","volume":"13","author":"Diamond, R.","year":"1991","unstructured":"Diamond R. The growing problem of mycoses in patients infected with the human immunodeficiency virus. Rev Infect Dis 1991;13:480-6.","journal-title":"Rev Infect Dis"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/0030-4220(90)90322-J","article-title":"Prevalence of oral lesionis among HIV-infected intravenous drug abusers and other risk groups","volume":"69","author":"Barone, R.; Ficarra, G.; Gaglioti, D.; Orsi, A.; Mazzotta, F.","year":"1990","unstructured":"Barone R, Ficarra G, Gaglioti D, Orsi A, Mazzotta F. Prevalence of oral lesionis among HIV-infected intravenous drug abusers and other risk groups. Oral Surg Oral Med Oral Pathol 1990;69:169-73.","journal-title":"Oral Surg Oral Med Oral Pathol"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1097\/00006454-199112000-00002","article-title":"Disseminated fungal infections in children infected with human immunodeficiency virus","volume":"10","author":"Leibovitz, E.; Rigaud, M.; Chandwani, S.; Kaul, A.; Greco, A.; Pollack, H.","year":"1991","unstructured":"Leibovitz E, Rigaud M, Chandwani S, Kaul A, Greco A, Pollack H, et al. Disseminated fungal infections in children infected with human immunodeficiency virus. Pediatr Infect DisJ 1991;10:888-94.","journal-title":"Pediatr Infect DisJ"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1056\/NEJM199103073241003","article-title":"Pulmonary aspergillosis in the acquired immunodeficiency syndrome","volume":"324","author":"Denning, D.; Follanbee, S.; Ml, Scolaro; Norris, S.; Edelstein, H.; Stevens, D.","year":"1991","unstructured":"Denning D, Follanbee S, Scolaro Ml, Norris S, Edelstein H, Stevens D. Pulmonary aspergillosis in the acquired immunodeficiency syndrome. N EnglJ Med 1991;324:654-62.","journal-title":"N EnglJ Med"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1093\/infdis\/164.6.1232","article-title":"Fluconazole failure in the treatment of invasive mycoses","volume":"164","author":"Evans, T.; Mayer, J.; Cohen, S.; Classen, D.; Carroll, K.","year":"1991","unstructured":"Evans T, Mayer J, Cohen S, Classen D, Carroll K. Fluconazole failure in the treatment of invasive mycoses.J I,nfect Dis 1991;164:1232-5.","journal-title":"J I, nfect Dis"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.1097\/00002030-199111000-00014","article-title":"Itraconazole versus ketoconazole in the treatment of oral and oesophageal candidosis in patients infected with HIV","volume":"5","author":"Smith, D.; Midgley, J.; Allan, M.; Connolly, G.; Gazzard, B.","year":"1991","unstructured":"Smith D, Midgley J, Allan M, Connolly G, Gazzard B. Itraconazole versus ketoconazole in the treatment of oral and oesophageal candidosis in patients infected with HIV. AIDS 1991;5:1367-71.","journal-title":"AIDS"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1016\/0016-5085(86)90946-7","article-title":"Ketoconazole-resistant candida esophagitis in patients with acquired immunodeficiency syndrome","volume":"90","author":"Tavitian, A.; Raufman, J.; Rosenthal, L.; Weber, J.; Webber, C.; Dinscoy, H.","year":"1986","unstructured":"Tavitian A, Raufman J, Rosenthal L, Weber J, Webber C, Dinscoy H. Ketoconazole-resistant candida esophagitis in patients with acquired immunodeficiency syndrome. Gastroenterology 1986;90:443-5.","journal-title":"Gastroenterology"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/0140-6736(91)90514-P","article-title":"Yeast susceptibility testing","volume":"338","author":"Dupouy-Camet, J.; Paugam, A.; Tourte-Scheaffer, C.","year":"1991","unstructured":"Dupouy-Camet J, Paugam A, Tourte-Scheaffer C. Yeast susceptibility testing. Lancet 1991;338:383.","journal-title":"Lancet"},{"key":"ref_11","first-page":"189","article-title":"AIDS-related esophagal candidosis in Africa. Pilot studv in Burundi with fluconazole","volume":"1","author":"Kadende, P.; Laroche, R.; Ndabaneze, E.; Marerwa, G.; Habonimana, D.; Floch, J.J.","year":"1991","unstructured":"Kadende P, Laroche R, Ndabaneze E, Marerwa G, Habonimana D, Floch JJ, et al. AIDS-related esophagal candidosis in Africa. Pilot studv in Burundi with fluconazole. Journal de Mvcologie Medicale 1991; 1: 189-92.","journal-title":"Journal de Mvcologie Medicale"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"175","DOI":"10.7326\/0003-4819-61-2-175","article-title":"Nephrotoxicity of amphotericin B. Early and late effects in 81 patients","volume":"61","author":"Butler, W.; Bennett, J.; Ailing, D.; Wertlake, P.; Utz, J.; Hill, G.","year":"1964","unstructured":"Butler W, Bennett J, Ailing D, Wertlake P, Utz J, Hill G. Nephrotoxicity of amphotericin B. Early and late effects in 81 patients. Ann Intern Med 1964;61: 175-87.","journal-title":"Ann Intern Med"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1093\/infdis\/120.4.427","article-title":"A pharmacologic guide to the clinical use of amphotericin B","volume":"120","author":"Bindschadler, D.; Bennett, J.","year":"1969","unstructured":"Bindschadler D, Bennett J. A pharmacologic guide to the clinical use of amphotericin B. J Infect Dis 1969;120:427-36.","journal-title":"J Infect Dis"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1093\/clinids\/13.3.474","article-title":"The use of amphotericin B in nosocomial fungal infection","volume":"13","author":"Perfect, J.; Pickard, W.; Hunt, D.; Palmer, B.; Schell, W.","year":"1991","unstructured":"Perfect J, Pickard W, Hunt D, Palmer B, Schell W. The use of amphotericin B in nosocomial fungal infection. Rev Infect Dis 1991;13:474-9.","journal-title":"Rev Infect Dis"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"334","DOI":"10.7326\/0003-4819-61-2-334","article-title":"Amphotericin B toxicity","volume":"61","author":"Utz, J.; Bennett, J.; Mi, Brandiss; Butler, W.; Hill, G.","year":"1964","unstructured":"Utz J, Bennett J, Brandiss Mi, Butler W, Hill G. Amphotericin B toxicity. Ann Intern Med 1964;61:334-54.","journal-title":"Ann Intern Med"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1093\/jac\/28.suppl_B.27","article-title":"Amphotericin B: an introduction","volume":"B):","author":"Warnock, D.","year":"1991","unstructured":"Warnock D. Amphotericin B: an introduction. J Antimicrob Chemother 1991;28(suppl B):27-38.","journal-title":"J Antimicrob Chemother"},{"key":"ref_17","first-page":"381","article-title":"Amphotericin B: deliver svstemss lntt'","volume-title":"irob.l il Chemother","volume":"34","author":"Bra jiirg lJ, Jowdcrly WN, Kobtayashi (i. Medoff G","year":"1990","unstructured":"Bra jiirg lJ,Jowdcrly WN, Kobtayashi (i. Medoff G. Amphotericin B: deliver svstemss lntt' irob.l il Chemother 1990:34:381-4."},{"issue":"1065-70","key":"ref_18","first-page":"21","article-title":"ui al. An emiutilsioni 'ornaulation ot 'amphotcricin B improves therapetltic index when treating svstemic mitriine candidiasis","volume-title":"Admillistrationi of' amphotericin B","volume":"158","author":"liarrcuth.r A. D)odge R, Blotidcaux A.","year":"1988","unstructured":"Kirsh R. (oldstein R, larloff' J, Parris D, Hook J, Hanna N, ui al. An emiutilsioni 'ornaulation ot 'amphotcricin B improves therapetltic index when treating svstemic mitriine candidiasis 7 Intfct Dos 1988;158:1065-70. 21 liarrcuth.r A. D)odge R, Blotidcaux A. Admillistrationi of' amphotericin B."},{"key":"ref_19","first-page":"\"615","article-title":"Effect of' rapid intravenous infusion on serum conicentratiions of amphotericin B. Applied. 1icrotbiiologN'","volume":"22","author":"Ficlds, B.; Bates, J.; Abernathy, R.","year":"1971","unstructured":"Ficlds B, Bates J, Abernathy R. Effect of' rapid intravenous infusion on serum conicentratiions of amphotericin B. Applied. 1icrotbiiologN' 1971;22:615-7. 27 (Casagrandc J, Pike M, Sitlith P. Ani improved iippriiximate fOrmula fotr calcLilatitag sample sizes for comparing two binomial distributions. BBittnieirics 1978;34:48-6. 2.8 'l'arala R, Stiiltlt J. Crvptiicoccosis treated by rapid inf'usion ofamnphotericin B. B.I] 1980;281:28.","journal-title":"BBittnieirics; Ani improved iippriiximate fOrmula fotr calcLilatitag sample sizes for comparing two binomial distributions"},{"key":"ref_20","first-page":"\"418","article-title":"Ccmparaitive safety, toleratice, atid pliariaiacokituctics of amphoitcricin B lipid complex and aniphotericiti B dcfoxvcholate in healthy male vsluntcers","volume":"164","author":"thiia J, MCMMlltiiis F.","year":"1991","unstructured":"Kat V, BlBcetett J, Aitiaitcta M\\, SiIiolskis M1(., MilcM:aliius E, (irascla DIM, et al. Ccmparaitive safety, toleratice, atid pliariaiacokituctics of amphoitcricin B lipid complex and aniphotericiti B dcfoxvcholate in healthy male vsluntcers. jInt,'tViDii 1991;164:418-21. 30) thiia J, MCMMlltiiis F. Ini vitro tumor necrosis factor iicdtiction assaf'or analysis of febrile toxicitv associated with amphotericin B preparations. Anltmicrtsh Agents C,hemother 1990;34:906-8.","journal-title":"jInt,'tViDii; Ini vitro tumor necrosis factor iicdtiction assaf'or analysis of febrile toxicitv associated with amphotericin B preparations"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1093\/infdis\/156.5.784","article-title":"Induction of prostaglandin svnthesis as the mechanism responsible for chills and fever produced by infuision of amphotericin B","volume":"156","author":"Gigliotti, F.; Shenep, J.; Lott, L.; Thornton, D.","year":"1987","unstructured":"Gigliotti F, Shenep J, Lott L, Thornton D. Induction of prostaglandin svnthesis as the mechanism responsible for chills and fever produced by infuision of amphotericin B. J Infect Dis 1987;156:784-9.","journal-title":"J Infect Dis"},{"key":"ref_22","first-page":"257","article-title":"How do the polyene macrolide antibiotics affect the cellular membrane properties?","volume":"864","author":"Bolard, J.","year":"1986","unstructured":"Bolard J. How do the polyene macrolide antibiotics affect the cellular membrane properties? Biochem Biophys Acta 1986;864:257-304.","journal-title":"Biochem Biophys Acta"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1128\/AAC.34.2.183","article-title":"Amphotericin B: currelnt understanding of mechanisms of action","volume":"34","author":"Brajtburg, J.; Powderly, W.; Kobayashi, G.; Medoff, G.","year":"1990","unstructured":"Brajtburg J, Powderly W, Kobayashi G, Medoff G. Amphotericin B: currelnt understanding of mechanisms of action. Antimicrob Agents Chemother 1990;34: 183-8.","journal-title":"Antimicrob Agents Chemother"},{"key":"ref_24","first-page":"6122","article-title":"Unusual lipid structures","volume-title":"selectively reduce the Proc NatlAcadSci USA 1988","volume":"85","author":"Janoff, A.; Boni, L.; Popescu, M.; Minche, SR, Cullis; PR, Madden; T.D.","unstructured":"Janoff A, Boni L, Popescu M, Minche SR, Cullis PR, Madden TD, et al. Eileenjrns, Gjode, Helen F Unusual lipid structures selectively reduce the Proc NatlAcadSci USA 1988;85:6122-6."}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj.305.6859.921","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj.305.6859.921","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T05:10:59Z","timestamp":1766380259000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj.305.6859.921"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1992,10,17]]},"references-count":24,"journal-issue":{"issue":"6859","published-online":{"date-parts":[[1992,10,17]]},"published-print":{"date-parts":[[1992,10,17]]}},"alternative-id":["10.1136\/bmj.305.6859.921"],"URL":"https:\/\/doi.org\/10.1136\/bmj.305.6859.921","relation":{},"ISSN":["0959-8138","1468-5833"],"issn-type":[{"value":"0959-8138","type":"print"},{"value":"1468-5833","type":"electronic"}],"subject":[],"published":{"date-parts":[[1992,10,17]]}}}