Antimicrobials
Amphotericin B, Conventional

Amphotericin B, Conventional

Low
N/A
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Spectrum of Activity

Dosing

General Information

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.

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

Frequency depends on course, but daily reasonable during initiation

  • Nephrotoxicity ++
  • Hypotension
  • Tachycardia
  • Tachypnea
  • CNS effects: Headache, malaise, pain, delirium, paresthesias, arachnoiditis, neuralgias
  • GI disturbances: Anorexia, diarrhea, nausea heartburn
  • Anemia
  • Urinary retention

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.

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