Journal of Antimicrobial Chemotherapy (1994) 33, 203-213
© 1994 The British Society for Antimicrobial Chemotherapy
review-article |
Administering amphotericin B—a practical approach
aRegional Department of Infectious Diseases and Tropical Medicine, Monsall Hospital Manchester bDepartment of Medicine, Section of Infectious Diseases, University of Manchester, Hope Hospital Salford, Manchester, UK
Received 24 February 1993; accepted 23 July 1993
*Regional Department of Infectious Diseases and Tropical Medicine, North Manchester General Hospital, Delannay's Road, Manchester M8 6RB, UK.
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 stategies to reduce the incidence of infusion-related reactions and nephrotoxicity are also considered. Finally, detailed recommendations for the administration of amphotericin B are provided.
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