Infectious Disease consultation recommended.
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).
Amphotericin B lipid associated or azole therapy may be preferred.
Frequency depends on course, but daily reasonable during initiation
Infusion related symptoms
Electrolyte abnormalities
Main concern is concomitant nephrotoxins. Use should be minimized during amphotericin therapy.
Increased digoxin toxicity with hypokalemia.
Do not mistake amphotericin formulations; they are NOT interchangeable and have different dosing recommendations.
Premedication with acetaminophen, diphenhydramine or hydrocortisone are used. Meperidine may be used for rigors.
Pay careful attention to electrolyte and fluid status with boluses (usually 500 mL) of NS before and after infusion, as well as K and Mg supplementation PRN.
Antimicrobial class: Antifungal. Polyene.
Pregnancy category: B
Average serum half life: 24 hours
CSF penetration: Therapeutic with appropriate dosing but otherwise low. Remains effective for Cryptococcus.
Lung penetration: Therapeutic
Urine penetration: Therapeutic