Low
NA
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Ambisome - 3-6mg/kg IV daily infused over several hours
Abelcet - 5mg/kg IV daily infused over several hours
Discuss with dosing and premedication with Pharmacy
Fungicidal therapy of yeast/fungus/mold infection (not for use in urinary tract infection)
Invasive candidiasis, aspergillosis, cryptococcosis
Visceral/mucocutaneous Leishmaniasis
Induction therapy for dimorphic fungii (cocci, blasto, histo)
Laboratory
Twice-weekly Cr, K, Mg
Weekly LFTs and CBC
Clinical
Lower incidence of nephrotoxicity than amphotericin B deoxycholate
Infusion-related effects
Electrolyte disturbances (hypokalemia, magnesemia)
Main concern is concomitant nephrotoxins - use should be minimized during amphotericin therapy
Digoxin - increased digoxin toxicity with hypokalemia
Lipid associated AmB is taken up preferentially by phagocytic cells and concentrated at sites of infection while minimizing renal exposure
Premedication with acetaminophen, diphenhydramine, or hydrocortisone are used.
Meperidine may be used for rigors.
Careful attention to electrolyte and fluid status with boluses (usually 500mL) before and after infusion, as well as K and Mg supplementation PRN
Antimicrobial class: Antifungal - polyene - Lipid formulations (designed to minimize toxicity)
Average serum half life: 150 hours
Biliary penetration: Therapeutic
Lung penetration: Therapeutic
Urine penetration: Poor
