Liposomal amphotericin B in neonates with invasive candidiasis.

Liposomal amphotericin B (L-Amp B), a novel formulation of amphotericin B, is effective for the treatment of invasive fungal infections in children and adults and is associated with less toxicity than the conventional preparation. Data on the use of Liposomal amphotericin B in neonates is scarce. We describe the clinical course of two premature infants who were treated with Liposomal amphotericin B (one infant had candidemia, and the other had candidemia and meningitis), and provide a summary of previously published experience on this topic. Liposomal amphotericin B may be an option for therapy of invasive candidiasis in neonates who are at high risk of nephrotoxicity and other amphotericin-related reactions, but clinical trials are necessary to document its safety and efficacy in this age group.

Liposomal amphotericin B in neonates with invasive candidiasis.

Liposomal amphotericin B L-Amp B, a novel formulation of Amp B, is effective for the treatment of invasive fungal infections in children and adults and is associated with less toxicity than the conventional preparation. Data on the use of L-Amp B in neonates is scarce. We describe the clinical course of two premature infants who were treated with L-Amp B (one infant had candidemia, and the other had candidemia and meningitis), and provide a summary of previously published experience on this topic. L-Amp B may be an option for therapy of invasive candidiasis in neonates who are at high risk of nephrotoxicity and other amphotericin-related reactions, but clinical trials are necessary to document its safety and efficacy in this age group.

Improving utilization of intravenous immune globulin through concurrent use of an indication form.

OBJECTIVE: Based on the guidelines of the United States Joint Commission for Accreditation of Health Care Organizations for conducting a drug utilization evaluation, we evaluated the usage of intravenous immune globulin at our tertiary care hospital. METHODS: An initial concurrent evaluation of IVIG use showed deficiencies in both dosing and compliance with hospital policy, with regards to its use for unlabeled indications. Two follow-up evaluations were performed after the institution of an IVIG indication form, which was designed to accompany each order. RESULTS: We demonstrated consistent improvements in both dosing criteria, labeled IVIG use, and compliance with hospital policy its use in unlabeled indications. An ongoing prospective program targeting IVIG use, combined with the introduction of a simple indication form improved its utilization at our hospital.

Enteroviruses at a tertiary care center in Saudi Arabia, 1989-1995.

Enteroviruses (EVs) are among the most common viral pathogens affecting humans. Enterovirus (EV) infections occur worldwide in temperate climates with a marked summer/fall season and have a high year-round incidence in tropical and subtropical areas. In Saudi Arabia, the epidemiology of enteroviruses is unknown. Of the clinical specimens submitted for diagnosis during a six-year period (1989-1995) at King Faisal Specialist Hospital and Research Centre (KFSH&RC) in Riyadh, a wide variety of diseases were associated with the isolation of enteroviruses. Among the diseases were herpangina, sepsis-like illness, hand-foot-and-mouth syndrome, laryngotracheitis (croup), aseptic meningitis, pneumonia, and gastrointestinal illness. During the six-year study, a variety of enteroviruses were isolated. Although epidemics were seen in mid-winter and early spring, EV which may cause sporadic diseases were isolated in each of the 12 months. Health care providers must become aware of the epidemic potential not only in mid-winter and early spring, but also throughout the year, as this will aid in the diagnosis and management of this illness.