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The American Journal of Digestive Diseases

, Volume 15, Issue 11, pp 993–1002 | Cite as

Oral amphotericin B in the treatment of ulcerative intestinal diseases

  • M. Z. Sait
  • K. G. Rajagopal
  • F. Villa
  • F. Steigmann
Article

Abstract

Amphotericin B given parenterally is nephrotoxic. The drug is poorly absorbed from the normal gastrointestinal tract and has no side effects. We wished to determine whether oral Amphotericin B is absorbed from the gastrointestinal tract of patients with intestinal ulcerations, since this drug might occasionally be needed for candidiasis after prolonged antibiotic therapy. Patients hospitalized for ulcerative colitis or enteritis were given 100 mg Amphotericin B suspension, 4 times daily for 5 days. After a 2-day rest period, they received 200 mg, 4 times daily, and finally 500 mg, 4 times daily. Antifungal activity of serum; urinary pH, specific gravity, protein and sediment; BUN and potassium were determined before, during and at the end of each test period; creatinine clearance and PSP, at the start and at the end of each test period. No kidney or electrolyte disturbance and only little absorption of the antifungal agent was found. No significant subjective symptoms, such as abdominal pain, nausea, vomiting, heartburn or headache were noted.

Keywords

Gastrointestinal Tract Specific Gravity Ulcerative Colitis Amphotericin Antifungal Activity 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Bell NH, Andriole VT, Sabesin SN, et al: On the nephrotoxicity of amphotericin B in man. Amer J Med 33:64–69, 1962PubMedGoogle Scholar
  2. 2.
    Sanford WG, Rasch JR, Stonehill RB: A therapeutic dilemma: the treatment of disseminated coccidioidomycosis with amphotericin B. Ann Intern Med 56:553–563, 1962PubMedGoogle Scholar
  3. 3.
    Rhoades ER, Ginn HE, Muchmore HG. et al: The effect of amphotericin B upon renal function in man, Antimicrobial Agents Annual. New York. Plenum Press, 1961, p 539Google Scholar
  4. 4.
    Beard WH, Richert JH, Taylor RR: The treatment of deep mycotic infections with amphotericin B. Ann Rev Resp Dis 81:43–57, 1960Google Scholar
  5. 5.
    Holeman CW, Einstein H: The toxic effects of amphotericin B in man. Calif Med 99:90–93, 1963PubMedGoogle Scholar
  6. 6.
    McCherney JA, Marquardt JF: Hypokalemia paralysis induced by amphotericin B. JAMA 189:1029–1031, 1964PubMedGoogle Scholar
  7. 7.
    Eknoyan G, Roberts AD: Nephrotoxicity of amphotericin B: observations on the mechanism of hypokalemia. Proceedings of the Second Interscience Conference on Antimicrobial Agents and Chemotherapy. Chicago. 1962, p 497Google Scholar
  8. 8.
    McCurdy DK, Frederic M, Elkinton JR: Renal tubular acidosis due to amphotericin B. Clin Res 12:471, 1964Google Scholar
  9. 9.
    Douglas JB, Healy JK: Nephrotoxic effects of amphotericin B including renal tubular acidosis. Amer J Med 46:154–162, 1969PubMedGoogle Scholar
  10. 10.
    Levinsky NG, Davidson DG, Berliner RW: Effects of reduced glomerular filtration on urine concentration in the presence of antidiuretic hormone. J Clin Invest 38:730–740, 1959PubMedGoogle Scholar
  11. 11.
    Levitt MF, Levy MS, Polimeros D: The effect of a fall in filtration rate on solute and water excretion in hydropenic man. J Clin Invest 38:463–473, 1959PubMedGoogle Scholar
  12. 12.
    Rubini ME: Water excretion in potassium deficient man. J Clin Invest 40:2215–2224, 1961PubMedGoogle Scholar
  13. 13.
    Butler WT, Bennett JE, Hill GJ, et al: Electrocardiographic and electrolyte abnormalities caused by amphotericin B in dog and man. Proc Soc Exp Biol Med 116:857–863, 1964PubMedGoogle Scholar
  14. 14.
    Mendoza SA, Handler JS, Orloff J: Effect of amphotericin B on permeability and short-circuit current in toad bladder. Amer J Physiol 213:1263–1268, 1967PubMedGoogle Scholar
  15. 15.
    Takacs FJ, Tomkiewicz ZM, Merrill JP: Amphotericin B nephrotoxicity with irreversible renal failure. Ann Intern Med 59:716–724, 1963PubMedGoogle Scholar
  16. 16.
    Iovine G, Berman LB, Halikis DW, et al: Nephrotoxicity of amphotericin B. Arch Intern Med 112:853–867, 1963PubMedGoogle Scholar
  17. 17.
    Finlayson GR, Miranda JL, Mailman CJ. et al: Sporotrichosis treated with amphotericin B: nephrocalcinosis as a therapeutic complication. Arch Derm 89:730–733, 1964PubMedGoogle Scholar

Copyright information

© Hoeber Medical Division • Harper & Row, Publishers, Incorporated 1970

Authors and Affiliations

  • M. Z. Sait
    • 1
    • 2
  • K. G. Rajagopal
    • 1
    • 2
  • F. Villa
    • 1
    • 2
  • F. Steigmann
    • 1
    • 2
  1. 1.From The Hektoen Institute for Medical Research and the Department of Gastroenterology of Cook County Hospital, and the Departments of Internal Medicine, Stritch School of MedicineLoyola UniversityUSA
  2. 2.College of MedicineUniversity of IllinoisChicago

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