and/or distribution equilibrium. RES, cells of the reticular endothelial system. The Solubility Ceiling: A Rationale for Continuous

Abstract

Sir—We read with interest the recent open-label study by Imhof et al. [1] re-porting the tolerability of high-dose am-photericin B (AmB) deoxycholate (AmB-d) administered by continuous infusion. Similar to previous reports [2, 3], contin-uously infused AMB-d was found to result in a lower rate of nephrotoxicity and fewer infusion-related reactions than did a 4-h infusion of AmB-d at the same daily dose. Despite these promising findings, the practice of administering AmB-d by con-tinuous infusion has not been widely adopted by clinicians for 3 reasons: (1) comparative data supporting the efficac