Gavalda J, Monforte V, Roman A, Bravo C, Simo M, Aguade S, Soriano B, Pou L, Maestre J, Morell F, Pahissa A; Interscience Conference on Antimicrobial Agents and Chemotherapy.
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 1999 Sep 26-29; 39: 47 (abstract no. 1925).
Hosp. Vall d'Hebron, Barcelona, Spain
Nebulized amphotericin B is used for prevention of aspergillosis in lung transplantation patients. However, the pharmocokinetics of this drug in respiratory samples and distribution in lung allografts are unknown. Our aim was to describe the pharmacokinetics and assess the distribution of n-Amp in lung allograft recipients. Concentrations of amphotericin B were measured in bronchial lavage (BL) and bronchoalveolar lavage (BAL) samples. BL and BAL were obtained from 115 consecutive bronchoscopies in 39 patients. Procedures were performed at 4, 12, 24 and 48 hours post-nebulization of 6 mg amphotericin B deoxicolate. HPLC was used to measure drug concentrations (mg/ml). Results were given as mean (95% CI of the mean). Distribution studies were done in 17 lung transplant recipients. 25 mg of Amphotericin B deoxicolate was labelled with stannous clorur and, then mixed with 400-600 mBq of [99m]Tc. Immediately following inhalation, deposition images were obtained by scintigraphy in 6 standard projections of 150 s each. Finally 250 Mbq of [99m]Tc-labelled macroaggregates were injected and comparative projections were obtained. Quantitative distribution of the tracer either in ventilation and perfusion imaging were obtained. [table: see text] All the patients showed acceptable delivery of n-Amp to the allografts. There was a close correlation between regional ventilation distribution and regional perfusion. In single lung transplantation, greatest activity (>2/3) was seen in the allograft. In double lung recipients, lung ventilation was symmetrical. Less n-Amp was deposited in the upper lobes than in the lower.CONCLUSIONS: Nebulized amphotericin B once a day is supported by these results. The distribution of n-Amp in the allograft and in the native lung seems to be acceptable, with a predominance to the allograft in recipients of a single lung.
Publication Types:
Keywords:
- Amphotericin B
- Aspergillosis
- Bronchoscopy
- Humans
- Lung
- Lung Diseases, Fungal
- Lung Transplantation
- Nebulizers and Vaporizers
- Respiration
- Respiratory System
- instrumentation
- pharmacokinetics
- supply & distribution
- surgery
- transplantation
Other ID:
UI: 102244688
From Meeting Abstracts