Administering amphotericin B--a practical approach.
Despite the introduction in recent years of novel antifungal agents, the potency and broad spectrum of activity of amphotericin B have ensured that it remains the treatment of choice for most deep-seated mycoses. However, this agent is not without significant toxicity, particularly in patients who are already seriously ill and/or who are receiving other potentially nephrotoxic drugs. We review the various routes by which amphotericin B can be administered, focusing mainly on the intravenous route. The use of more rapid infusion rates, lipid-complexed preparations, sodium supplementation in salt-depleted patients and strategies to reduce the incidence of infusion-related reactions and nephrotoxicity are also considered. Finally, detailed recommendations for the administration of amphotericin B are provided.
Khoo
S H
SH
Regional Department of Infectious Diseases and Tropical Medicine, Monsall Hospital, Manchester, UK.
Bond
J
J
Denning
D W
DW
D000666:Amphotericin B / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D002626:Chemistry, Pharmaceutical; D004333:Drug Administration Routes; D004347:Drug Interactions; D005658:Fungi / Q000187:drug effects; D006801:Humans; D007262:Infusions, Intravenous; D007674:Kidney Diseases / Q000139:chemically induced; D009181:Mycoses / Q000188:drug therapy*
D000666:Amphotericin B