Antimicrobials
Amphotericin B Deoxycholate

Amphotericin B Deoxycholate

Restricted

Low
N/A

Spectrum of Activity

General Information

Administration

  • Infused over 4-6 hours
  • Pre-medication 30-60 minutes before administration (See additional information)

Preparation

  • Add 10mL of SWFI (without bacteriostatic agent) to each vial
  • Further dilute with 250-500mL of D5W
  • Final concentration not to exceed 0.1 mg/mL (peripheral) or 0.25 mg/mL (central)

Compatibility

  • D5W

Fungicidal therapy of yeast/fungus/mold infection, especially of the urinary tract as lipid formulations are otherwise preferred to minimize toxicity.

Induction therapy for dimorphic fungii (cocci, blasto, histo).

  • Renal function
  • K+
  • Mg++
  • HCO3-
  • Liver enzymes
  • CBC

Frequency depends on course, but daily reasonable during initiation

  • Nephrotoxicity
  • Anemia
  • Phlebitis
  • Arachnoiditis
  • Urinary retention
  • Paresthesias

Infusion related symptoms

  • Fever
  • Rigors
  • N/V
  • Headache

Electrolyte abnormalities

  • HypoK and HypoMg
  • Loss of bicarb
  • See "Additional Information"

Main concern is concomitant nephrotoxins. Use should be minimized during amphotericin therapy.

Increased digoxin toxicity with hypokalemia.

Antimicrobial class: Antifungal. Polyene

Pregnancy category: B

Average serum half life: 24 hours

Urine penetration: Therapeutic

Lung penetration: Therapeutic

CSF penetration: Poor in adults, high inter-patient variability in preterm neonates.

Fungizone IV

Premedication with NSAIDs/acetaminophen, diphenhydramine or hydrocortisone are used. Meperidine may be used for rigors.

Pay careful attention to electrolyte and fluid status with boluses (usually 500mL) of NS before and after infusion, as well as K and Mg supplementation PRN.