Spectrum: Local Antimicrobial Stewardship, for Prisma Health Children’s Hospital-Midlands

Amphotericin B Deoxycholate

C. diff Risk

Low

Oral Bioavailability

NA

Approximate Cost

$$$

Spectrum Of Activity

General Spectrum of Activity

Spectrum Of Activity

Dosing

Pediatric

1 mg/kg, IV, q24hr. Infuse over 4 hours.

Neonatal

1 mg/kg, IV, q24hr. Infuse over 4 hours.

Renal

Contact pharmacy for more information regarding use in renal impairment.

General Information

Common Usage

Common Usage

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)

Drug Monitoring

Drug Monitoring

Renal function, fluid status, serum electrolytes (K, Mg)

Liver enzymes, CBC with differential

Adverse Effects

Adverse Effects

Infusion related symptoms: fever/rigors/N/V/headache

Electrolyte abnormalities - hypokalemia and hypomagnesemia, loss of bicarb

Nephrotoxicity ++

Anemia

Phlebitis

Major Interactions

Major Interactions

Enhance nephrotoxic effect with concomitant use of other nephrotoxins - use should be minimized during amphotericin therapy

Additional Information

Additional Information

Premedication with acetaminophen, diphenhydramine, or hydrocortisone for infusion related symptoms

Pharmacology

Pharmacology

Antimicrobial class: Antifungal - polyene

Average serum half life:

  • Premature neonates (GA: 27.4 ± 5 weeks): 14.8 hours (range: 5 to 82 hours)

  • Infants and Children (4 months to 14 years): 18.1 ± 6.6 hours (range: 11.9 to 40.3 hours)

Route of Elimination: Urine (2% to 5% unchanged); ~40% eliminated over 7-day period and may be detected in urine for up to 8 weeks after discontinued use