2-HOUR VERSUS 6-HOUR ADMINISTRATION OF AMPHOTERICIN-B IN THE TREATMENT OF KALA-AZAR

In a randomised study, 50 parasitologically confirmed cases of kala-azar were allocated to two treatment groups: group A received amphotericin B in 5% glucose infusion for 6 h and group B for 2 h. Amphotericin B was given at an initial dosage of 0.05 mg/kg body weight, increasing to 1 mg/kg body weight on day 5, and this dose was given daily until patients had received a total of 20 mg/kg body weight. Toxicities like rise in serum creatinine, fall in serum potassium levels and diminution in appetite were no different in the two groups. There was no difference in clinical, parasitological and ultimate cures between the two groups. Man-hours spent in treating patients in the 2-h infusion group were one-third of the time with the 6-h infusion group. It was concluded that 2-h infusion of amphotericin B caused fewer infusion-related toxicities (shivering and fever) and saved time spent in treating patients; hence it should be recommended for use.