Evidence map›Paper›PMID 27467556›Full record

ArticlePLoS neglected tropical diseases2016

Prevalence and Hospital Management of Amphotericin B Deoxycholate-Related Toxicities during Treatment of HIV-Associated Cryptococcal Meningitis in South Africa.

Susan Meiring, Melony Fortuin-de Smidt, Ranmini Kularatne, Halima Dawood, Nelesh P Govender, GERMS-SA

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PLoS neglected tropical diseases, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 5 pooled it
3.1field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 5 syntheses or guidelines pooled it, 32 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Susan MeiringNational Institute for Communicable Diseases (NICD), a Division of the National Health Laboratory Service (NHLS), Johannesburg, South Africa.ORCID 0000-0003-4508-5469
Melony Fortuin-de SmidtNational Institute for Communicable Diseases (NICD), a Division of the National Health Laboratory Service (NHLS), Johannesburg, South Africa.
Ranmini KularatneFaculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Halima DawoodPietermaritzburg Hospital Complex, Pietermaritzburg and University of KwaZulu-Natal, Durban, South Africa.
Nelesh P GovenderNational Institute for Communicable Diseases (NICD), a Division of the National Health Laboratory Service (NHLS), Johannesburg, South Africa.
GERMS-SA
National Health Laboratory Service · ZAUmkhuseli Innovation and Research Management · ZA

Funding

PS08-868, S. Africa: EXPANSION OF HIV/AIDS, STD AND TB LABORATORY ACTIVITIES AT THE NATIONAL INSTITUTEU2GPS001328 · PS · NATIONAL HEALTH LABORATORY SERVICE · PI VAN HEERDEN, DR. JOHAN · 2008 to 2012
$44.4M
NCHHSTP CDC HHS U2G PS001328PEPFAR
6 · The paper itself

Abstract

backgroundWe aimed to establish the prevalence of amphotericin B deoxycholate (AmBd)-related toxicities among South African patients with cryptococcosis and determine adherence to international recommendations to prevent, monitor and manage AmBd-related toxicities.

methodsClinical data were collected from cases of laboratory-confirmed cryptococcosis at 25 hospitals, October 2012 -February 2013. Anemia was defined as hemoglobin (Hb) concentration <10 g/dl, hypokalemia as serum potassium (K) <3.4 mEq/L and nephrotoxicity as an increase in serum creatinine (Cr) to >1.1 times the upper limit of normal. To determine adherence to toxicity prevention recommendations, we documented whether baseline Hb, K and Cr tests were performed, whether pre-emptive hydration and IV potassium chloride (KCl) was administered prior to 80% and 60% of AmBd doses and whether daily oral KCl supplementation was given ≥60% of the time. To determine adherence to monitoring recommendations, we ascertained whether a daily fluid chart was completed, Hb was monitored weekly and K or Cr were monitored bi-weekly.

resultsOf 846 patients, clinical data were available for 76% (642/846), 82% (524/642) of whom received AmBd. Sixty-four per cent (n = 333) had documented baseline laboratory tests, 40% (n = 211) were given pre-emptive hydration and 14% (n = 72) and 19% (n = 101) received intravenous and oral KCl. While on AmBd, 88% (n = 452) had fluid monitoring; 27% (n = 142), 45% (n = 235) and 44% (n = 232) had Hb, K and Cr levels monitored. Toxicities developed frequently during treatment: anemia, 16% (86/524); hypokalemia, 43% (226/524) and nephrotoxicity, 32% (169/524).

conclusionAmBd-related toxicities occurred frequently but were potentially preventable with adequate monitoring, supplemental fluid and electrolyte therapies.

Indexed as

Amphotericin BAntifungal AgentsDeoxycholic AcidDrug CombinationsFemaleHIV InfectionsHospitalizationHumansMaleMeningitis, CryptococcalPrevalenceRetrospective StudiesSouth AfricaAmphotericin Bamphotericin B, deoxycholate drug combinationAntifungal AgentsDeoxycholic AcidDrug Combinations

Identifiers

PMID27467556
PMCPMC4965057
OpenAlexW2499686760

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.