2014 年 40 巻 2 号 p. 94-99
There is less emergence of renal toxicity in Liposomal-amphotericin B (L-AMB) than amphotericin B (AMPH-B). However, there have been few reports on the analysis of this factor. I examined the factors involved in renal function decline via the creatinine clearance (Ccr) for 44 cases of L-AMB administered in our hospital. Reduced renal function was observed in 15 cases (34.1%). Multivariate logistic regression analysis for each factor revealed that Ccr ≧ G 1 (P = 0.006, odds ratio: 12.968, 95% confidence interval: 2.085 - 80.643) was a factor in the occurrence of decreased renal function. Results were subjected to multiple regression analysis of the dependent variable amount of change in Ccr before and after administration, and a significant statistical effect was shown by two factors. One is administration at the start of Ccr (P = 0.007); the other is the administration of concomitant medications (P = 0.04). Pharmacists used L-AMB administration to predict in advance the degree of renal function decline, and a regression equation was obtained. As pharmacists prescribe administration depending on the results, L-AMB is prescribed by doctors. For cases which can be a first choice, more aggressive? We believe that establishment of such a system would be ideal.