Antimicrobials
Amphotericin B deoxycholate

Amphotericin B deoxycholate

Low
N/A
$75/day

Dosing

General Information

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

Infusion related symptoms: fever/rigors/N/V/headache (see additional information)

Electrolyte abnormalities - hypoK and hypoMg, loss of bicarb (see additional information re: electrolyte infusions)

Nephrotoxicity ++ Anemia Phlebitis Arachnoiditis Urinary retention Paresthesias

Main concern is concomitant nephrotoxins - use should be minimized during amphotericin therapy

Digoxin - increased digoxin toxicity with hypokalemia

Orderset exists on SCM re: Premedication with acetaminophen, diphenhydramine, and hydrocortisone. Meperidine may be used for rigors.

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

Antimicrobial class: Antifungal - polyene

Pregnancy category: B

Average serum half life: 24.0

CSF penetration: Therapeutic

Lung penetration: Therapeutic

Urine penetration: Therapeutic