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Amphotericin B deoxycholate (conventional): Drug information

Amphotericin B deoxycholate (conventional): Drug information
(For additional information see "Amphotericin B deoxycholate (conventional): Patient drug information" and see "Amphotericin B deoxycholate (conventional): Pediatric drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)
ALERT: US Boxed Warning
Appropriate use:

This drug should be used primarily for treatment of patients with progressive and potentially life-threatening fungal infections; it should not be used to treat noninvasive forms of fungal disease such as oral thrush, vaginal candidiasis, and esophageal candidiasis in patients with normal neutrophil counts.

Error prevention:

Exercise caution to prevent inadvertent overdose with amphotericin B. Verify the product name and dosage if dose exceeds 1.5 mg/kg.

Brand Names: Canada
  • Fungizone IV
Pharmacologic Category
  • Antifungal Agent, Parenteral
Dosing: Adult

Note: Formulation: Conventional amphotericin formulations (deoxycholate [Amphocin, Fungizone]) may be confused with lipid-based formulations (AmBisome, Abelcet, Amphotec). Lipid-based and conventional formulations are not interchangeable and have different dosage recommendations. Overdoses have occurred when conventional formulations were dispensed inadvertently for lipid-based products. Premedication: To minimize infusion-related immediate reactions, premedicate with the following 30 to 60 minutes prior to drug administration: acetaminophen, diphenhydramine, and/or hydrocortisone. If the patient experiences rigors during the infusion, meperidine may be administered (HHS [OI adult] 2022; Sharkey 1996; manufacturer's labeling). Preinfusion administration of 1 L of NS may reduce the risk of nephrotoxicity during treatment (HHS [OI adult] 2022; manufacturer's labeling). Test dose: A test dose of 1 mg in 20 mL D5W administered over 20 to 30 minutes may be considered.

Usual dosage range: IV: 0.5 to 1 mg/kg/day (range: 0.3 to 1.5 mg/kg/day); maximum dose: 1.5 mg/kg/day. Note: Lipid-based formulations of amphotericin B are generally preferred for treatment of systemic infections because they demonstrate comparable efficacy and better tolerability (ECMM/MSG-ERC [Cornely 2019]; IDSA [Pappas 2016]; IDSA [Patterson 2016]; IDSA [Wheat 2007]).

Aspergillosis, endophthalmitis

Aspergillosis, endophthalmitis

Note: Administer a combination of both intraocular (intravitreal and/or intracameral depending on sites of involvement) and systemic (IV or oral) antifungal therapy (IDSA [Patterson 2016]).

Intraocular:

Intravitreal injection: For involvement of the vitreous: 5 to 10 mcg per 0.1 mL sterile water as a single intravitreal dose; may be repeated in several days as clinically indicated (Chakrabarti 2008; Durand 2022a; IDSA [Patterson 2016]).

Intracameral injection: For involvement of the aqueous humor: 5 mcg per 0.1 mL sterile water as a single intracameral (into the anterior chamber) dose (Durand 2022a; Kuriakose 2002; Yilmaz 2007). Note: May also consider intravitreal injection even if vitritis is not apparent, as occult vitreal involvement is possible (Durand 2022a).

Aspergillosis, invasive

Aspergillosis, invasive (including disseminated and extrapulmonary) (alternative agent):

Note: Optimal dose not defined; reserve for use in resource-limited settings when no alternatives are available (IDSA [Patterson 2016]).

IV: 1 to 1.5 mg/kg/day (Burch 1987; Herbrecht 2002). Minimum treatment duration is 6 to 12 weeks depending on site of infection, extent of disease, and level/duration of immunosuppression (IDSA [Patterson 2016]).

Blastomycosis, moderately severe to severe, non-CNS disease

Blastomycosis, moderately severe to severe, non-CNS disease: IV: 0.7 to 1 mg/kg/day for 1 to 2 weeks or until improvement, followed by oral itraconazole (IDSA [Chapman 2008]).

Candidiasis

Candidiasis:

CNS infection (failed to respond to systemic therapy and device removal or when ventricular device cannot be removed) (off-label): Intraventricular: 0.01 to 0.5 mg per 2 mL of an extemporaneously prepared solution in D5W administered through the device into the ventricle (IDSA [Pappas 2016]; IDSA [Tunkel 2017]).

Endophthalmitis ( with or without vitritis):

Note: Administer a combination of both intraocular (intravitreal and/or intracameral depending on sites of involvement) and systemic (IV or oral) antifungal therapy. For patients with endogenous endophthalmitis without vitritis or macular involvement, intraocular antifungals may not be necessary (Durand 2022b; Durand 2022c).

Intraocular:

Intravitreal injection: 5 to 10 mcg per 0.1 mL sterile water as a single intravitreal dose (IDSA [Pappas 2016]). Intravitreal dose may be repeated in several days if no improvement (Durand 2022b; Durand 2022c).

Intracameral injection: For exogenous cases involving primarily the aqueous: 5 mcg per 0.1 mL sterile water as a single intracameral (into the anterior chamber) dose. Note: May also consider intravitreal injection even if vitritis is not apparent, as occult vitreal involvement is possible (Durand 2022c).

Esophageal, refractory disease (alternative agent) (off-label use):

Note: Reserve use for patients who have inadequate response to or who are unable to take other agents (Kauffman 2021a).

IV: 0.3 to 0.7 mg/kg/day. Transition to an oral antifungal once patient tolerates oral intake if susceptibility allows; total antifungal duration is 14 to 28 days (HHS [OI adult] 2022]; IDSA [Pappas 2016]; Kauffman 2021a).

Invasive candidiasis (alternative agent): IV: 0.5 to 0.7 mg/kg/day; dose may be increased to as high as 1 mg/kg/day for infections caused by C. glabrata or C. krusei. Note: Given poor tolerability (eg, nephrotoxicity, infusion-related toxicity), experts preferentially recommend lipid formulations when available (IDSA [Pappas 2016]).

Oropharyngeal, refractory disease (alternative agent) (off-label use):

Note: Reserve use for patients who have inadequate response to or who are unable to take other agents (Kauffman 2021b).

Oral: 500 mg of an extemporaneously compounded 100 mg/mL suspension 3 to 4 times daily for 14 to 28 days; swish in the mouth and retain for as long as possible (several minutes) before swallowing (Fichtenbaum 2000; IDSA [Pappas 2016]; Kauffman 2021b; Talliandier 2000).

Urinary tract infection (off-label use):

Candiduria (asymptomatic) in patients undergoing urologic procedures: IV: 0.3 to 0.6 mg/kg/day for several days before and after the procedure (IDSA [Pappas 2016]).

Cystitis (symptomatic), fluconazole-resistant species (eg, C. glabrata, C. krusei):

Bladder irrigation (off-label route): Irrigate with 50 mg amphotericin B deoxycholate diluted in 1 L of sterile water once daily for 5 days. Note: Use of bladder irrigation is generally discouraged, especially in patients who would not otherwise require an indwelling catheter (IDSA [Pappas 2016]).

IV: 0.3 to 0.6 mg/kg/day for 1 to 7 days (IDSA [Pappas 2016]).

Fungus balls: Irrigation via nephrostomy tubes (off-label route): Irrigate with an extemporaneously prepared solution of 25 to 50 mg in 200 to 500 mL sterile water (final concentration range: 0.05 to 0.25 mg/mL); use in combination with systemic antifungal therapy (IDSA [Pappas 2016]).

Pyelonephritis, fluconazole-resistant species (eg, C. glabrata, C. krusei): IV: 0.3 to 0.6 mg/kg/day for 1 to 7 days (with or without flucytosine for fluconazole-resistant C. glabrata) (IDSA [Pappas 2016]).

Vulvovaginal, caused by C. glabrata (alternative agent) (off-label use): Intravaginal: 3% to 4% extemporaneously compounded cream: 1 applicatorful (~5 g) once daily (at bedtime) for 14 days (IDSA [Pappas 2016]; Sivasubramanian 2009; Sobel 2021). Note: Reserve for patients with no other clear cause of symptoms (Sobel 2021). May also be used in combination with intravaginal flucytosine (Challenor 2012; Hettiarachchi 2010; IDSA [Pappas 2016]; White 2001).

Coccidioidomycosis, severe, nonmeningeal infection

Coccidioidomycosis, severe, nonmeningeal infection: IV: 0.5 to 1 mg/kg/day until clinical improvement, then switch to an oral azole (HHS [OI adult] 2022; IDSA [Galgiani 2016]). Note: Some experts suggest initiating the oral azole at the same time as amphotericin B deoxycholate and continuing the oral azole when amphotericin B deoxycholate is discontinued (HHS [OI adult] 2022).

Cryptococcal meningoencephalitis, disseminated disease, or severe pulmonary disease

Cryptococcal meningoencephalitis, disseminated disease, or severe pulmonary disease:

Resource-rich settings (when a lipid formulation of amphotericin B cannot be used): IV: Induction therapy: 0.7 to 1 mg/kg/day in combination with flucytosine (preferred) or fluconazole (if flucytosine cannot be used) for ≥2 weeks (HHS [OI adult 2022]; IDSA [Perfect 2010]).

Resource-limited settings (if liposomal amphotericin B is not available) in patients with HIV: IV: Induction therapy: 1 mg/kg/day in combination with flucytosine for 7 days followed by fluconazole for ≥7 days. Note: If flucytosine is not available, amphotericin B may be given at the same dose in combination with fluconazole for 14 days (WHO 2022).

Note: Duration of induction therapy may be extended in patients who cannot use combination therapy or who have evidence of neurological complications (HHS [OI adult] 2022; IDSA [Perfect 2010]). Induction therapy is followed by consolidation and maintenance therapy with fluconazole (AST-IDCOP [Baddley 2019]; HHS [OI adult 2022]; IDSA [Perfect 2010]).

Histoplasmosis

Histoplasmosis (alternative agent): Moderately severe to severe pulmonary or disseminated disease: IV: 0.7 to 1 mg/kg/day for 1 to 2 weeks (at least 2 weeks in patients with HIV), followed by oral itraconazole (Baddley 2022; IDSA [Wheat 2007]; Johnson 2002). Some experts prefer to use the higher end of the dosing range (eg, 1 mg/kg/day) in patients with HIV (Baddley 2022).

Leishmaniasis

Leishmaniasis (alternative agent):

Cutaneous: IV: 0.5 to 1 mg/kg/dose once daily or every other day for a total cumulative dose of ~15 to 30 mg/kg (IDSA/ASTMH [Aronson 2016]).

Mucosal: IV: 0.5 to 1 mg/kg/dose once daily or every other day for a total cumulative dose of ~20 to 45 mg/kg (IDSA/ASTMH [Aronson 2016]).

Visceral (off-label use): IV: 1 mg/kg/dose once daily or every other day for a total cumulative dose of 15 to 20 mg/kg (IDSA/ASTMH [Aronson 2016]).

Visceral, patients with HIV (off-label use): IV: 0.5 to 1 mg/kg/dose once daily for a total cumulative dose of 1,500 to 2,000 mg (HHS [OI adult] 2017).

Sporotrichosis, pulmonary, meningeal, osteoarticular, or disseminated

Sporotrichosis, pulmonary, meningeal, osteoarticular, or disseminated: IV: 0.7 to 1 mg/kg/day, followed by oral itraconazole after a favorable response is seen with initial amphotericin therapy (IDSA [Kauffman 2007).

Talaromycosis

Talaromycosis (formerly penicilliosis) (alternative agent) (off-label use): IV: 0.7 mg/kg/day for 2 weeks (if liposomal amphotericin B unavailable) followed by oral azole consolidation therapy (HHS [OI adult] 2022).

Dosing: Kidney Impairment: Adult

The renal dosing recommendations are based upon the best available evidence and clinical expertise. Senior Editorial Team: Bruce Mueller, PharmD, FCCP, FASN, FNKF; Jason A. Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC; Michael Heung, MD, MS.

Note: Due to the risks of nephrotoxicity associated with amphotericin B deoxycholate, a conventional amphotericin formulation, only use when benefits outweigh the risks. Lipid-based amphotericin preparations are associated with a lower risk of nephrotoxicity and are preferred in patients with preexisting kidney impairment (including patients on hemodialysis or peritoneal dialysis who have significant residual renal function). If using amphotericin B deoxycholate, limiting dose and duration of treatment (as clinically appropriate), extending infusion time, avoiding concomitant nephrotoxic drugs, and hydration and sodium loading with 1 L of NS prior to starting therapy may reduce the risk of acute kidney injury. Monitor kidney function closely (Falagas 2013; Llanos 1991; Nemecek 2019; Peleg 2004; Rothenbühler 2018; manufacturer's labeling). For routes of administration other than IV (eg, intraocular), there are no specific dosage adjustments recommended (has not been studied in patients with kidney impairment); however, need for adjustment is unlikely (expert opinion).

Kidney impairment prior to treatment initiation:

Altered kidney function: IV: No dosage adjustment necessary for any degree of kidney impairment (only 2% to 5% excreted in biologically active form) (Nemecek 2019; Sinnollareddy 2012; expert opinion).

Augmented renal clearance (measured urinary CrCl ≥130 mL/minute/1.73 m2):

Note: Augmented renal clearance (ARC) is a condition that occurs in certain critically ill patients without organ dysfunction and with normal serum creatinine concentrations. Younger patients (<55 years of age) admitted post trauma or major surgery are at highest risk for ARC, as well as those with sepsis, burns, or hematologic malignancies. An 8- to 24-hour measured urinary CrCl is necessary to identify these patients (Bilbao-Meseguer 2018; Udy 2010).

IV: No dosage adjustment necessary (expert opinion).

Hemodialysis, intermittent (thrice weekly): Not significantly dialyzable (Gussak 2001):

IV: No dosage adjustment necessary (Heintz 2009).

Peritoneal dialysis: Not likely to be significantly dialyzable (highly protein bound with poor peritoneal penetration) (Li 2016; expert opinion):

IV: No dosage adjustment necessary (expert opinion).

CRRT: IV: No dosage adjustment necessary (Bellman 2003; Heintz 2009; Sinnollareddy 2012).

PIRRT (eg, sustained, low-efficiency diafiltration): IV: No dosage adjustment necessary (expert opinion).

Nephrotoxicity during treatment: Consider switching to an alternative antifungal agent or a lipid-based amphotericin formulation (expert opinion). However, if continued use of amphotericin B deoxycholate is deemed clinically appropriate, may consider interrupting therapy for 24 to 48 hours, then resume at one-half of the usual daily dose; the dosage may then be increased to the maximally tolerated dose (Maddux 1980). This approach will likely decrease amphotericin deoxycholate exposures, and so should be avoided in the acute phase of serious infections (expert opinion).

Dosing: Hepatic Impairment: Adult

No dosage adjustment provided in manufacturer’s labeling.

Dosing: Pediatric

(For additional information see "Amphotericin B deoxycholate (conventional): Pediatric drug information")

Medication errors, including deaths, have resulted from confusion between lipid-based forms of amphotericin (Abelcet, Amphotec, AmBisome) and conventional amphotericin B for injection; conventional amphotericin B for injection doses should not exceed 1.5 mg/kg/day

Note: Premedication: For patients who experience infusion-related immediate reactions, premedicate with the following drugs 30 to 60 minutes prior to drug administration: NSAID (with or without diphenhydramine) or acetaminophen with diphenhydramine or hydrocortisone. If the patient experiences rigors during the infusion, meperidine may be administered.

Test dose: Infants, Children, and Adolescents: IV: 0.1 mg/kg/dose to a maximum of 1 mg; infuse over 20 to 60 minutes; an alternative method to the 0.1 mg/kg test dose is to initiate therapy with 0.25 mg/kg amphotericin administered over 6 hours; frequent observation of the patient and assessment of vital signs during the first several hours of the infusion is recommended; many clinicians believe a test dose is unnecessary

General dosing, susceptible infections:

IV: Infants, Children, and Adolescents:

Initial: 0.25 to 0.5 mg/kg/dose once daily; gradually increase daily, usually in 0.25 mg/kg increments until the desired daily dose is reached (maximum daily dose: 1.5 mg/kg/day); in critically ill patients, more rapid dosage acceleration may be warranted (eg, ≥0.5 mg/kg daily dose increase); others have initiated at target dose for life-threatening infection (HHS [OI pediatric 2013])

Maintenance dose: 0.25 to 1 mg/kg/dose once daily; rapidly progressing disease may require short-term use of doses up to 1.5 mg/kg/day; once therapy has been established, amphotericin B may be administered on an every-other-day basis at 1 to 1.5 mg/kg/dose in some cases

Intrathecal, intraventricular, or intracisternal (preferably into the lateral ventricles through a cisternal Ommaya reservoir): Limited data available; dose variable: Infants, Children, and Adolescents: 0.01 to 1 mg; frequency varies widely in the literature; administration has been reported as daily, every other day and even twice weekly (Chiou 1994; IDSA [Pappas 2016]; Murphy 2000; Red Book [AAP 2015])

Irrigation, bladder: Infants, Children, and Adolescents: Limited data available: 50 mcg/mL solution, administered as either a continuous irrigation or as an intermittent irrigation 3 times daily with a dwell time of 60 to 90 minutes (Fisher 2011; Gubbins 1999); some experts have also recommended daily administration for 5 days for the treatment of cystitis due to fluconazole-resistant Candida species (C. glabrata, C. krusei) (IDSA [Pappas 2016])

Aspergillosis

Aspergillosis:

Prophylaxis, immunocompromised: Limited data available: Infants, Children, and Adolescents: Intranasal: 7 mg amphotericin B in 7 mL sterile water was placed in a De Vilbiss atomizer and the aerosolized solution was instilled intranasally to each nostril 4 times daily delivering an average of 5 mg amphotericin/day to reduce the frequency of invasive aspergillosis in neutropenic patients (Jeffery 1991)

Endocarditis: Children and Adolescents: IV: 1 mg/kg/dose once daily with or without flucytosine (AHA [Baltimore 2015])

Blastomycosis, moderately severe to severe disease

Blastomycosis (independent of HIV status), moderately severe to severe disease: Infants, Children, and Adolescents: IV: 0.7 to 1 mg/kg/dose once daily as initial therapy for 1 to 2 weeks, followed with oral itraconazole for a total of 12 months (IDSA [Chapman 2008])

Candidiasis, treatment

Candidiasis, treatment:

Invasive: Infants, Children, and Adolescents: IV: 0.5 to 1 mg/kg/dose once daily; duration of therapy dependent upon severity and site of infection (IDSA [Pappas 2016])

Endocarditis: Children and Adolescents: IV: 1 mg/kg/dose once daily with or without flucytosine (AHA [Baltimore 2015])

Esophageal:

Non-HIV-exposed/-infected: Infants, Children, and Adolescents: IV: 0.3 to 0.7 mg/kg/dose once daily; consider step down to an oral antifungal once patient is able to tolerate oral intake. In fluconazole-refractory disease, continue amphotericin B for 21 days (IDSA [Pappas 2016])

HIV-exposed/-infected:

Infants and Children: IV: 0.3 to 0.7 mg/kg/dose once daily (HHS [OI pediatric 2013])

Adolescents: IV: 0.6 mg/kg/dose once daily for 14 to 21 days (HHS [OI adult 2016])

Oropharyngeal, fluconazole-refractory:

Non-HIV-exposed/-infected: Infants, Children, and Adolescents: IV: 0.3 mg/kg/dose once daily (IDSA [Pappas 2016])

HIV-exposed/-infected:

Infants and Children: IV: 0.3 to 0.5 mg/kg/dose once daily (HHS [OI pediatric 2013])

Adolescent: IV: 0.6 mg/kg/dose once daily for 14 to 21 days (HHS [OI adult 2016])

Urinary tract infections (IDSA [Pappas 2016]):

Prophylaxis, urologic procedures in patients with candiduria: Infants, Children, and Adolescents: IV: 0.3 to 0.6 mg/kg/dose once daily for several days before and after procedure

Treatment:

Cystitis: Infants, Children, and Adolescents: IV:

Asymptomatic (high-risk patients): 1 mg/kg/dose once daily

Symptomatic (C. krusei or fluconazole-resistant C. glabrata): 0.3 to 0.6 mg/kg/dose once daily for 1 to 7 days

Pyelonephritis: Infants, Children, and Adolescents: IV: 0.3 to 0.6 mg/kg/dose once daily for 1 to 7 days; depending on organism, consider addition of flucytosine

Coccidioidomycosis

Coccidioidomycosis:

Non-HIV-exposed/-infected (IDSA [Galgiani 2005]): Infants, Children, and Adolescents:

Disseminated (non-CNS) disease: IV 0.5 to 1.5 mg/kg/dose every day or every other day; with or without concomitant azole antifungal; duration determined by clinical response

CNS disease: Intrathecal: 0.1 to 1.5 mg/dose; frequency ranging from daily to weekly (with or without concomitant azole therapy); initiate at a low dose and increase until intolerance is noted (eg, severe vomiting, exhaustion, or transient dose-related mental status changes); duration determined by clinical response

Pulmonary disease, diffuse: IV 0.5 to 1.5 mg/kg/dose every day or every other day for several weeks, followed by an oral azole antifungal for a total length of therapy ≥12 months

HIV-exposed/-infected: Disseminated (non-CNS) disease, diffuse pulmonary disease; severely ill:

Infants and Children: IV: 0.5 to 1 mg/kg/dose once daily until clinical improvement; minimum of several weeks of therapy (HHS [OI pediatric 2013])

Adolescents: IV: 0.7 to 1 mg/kg/dose once daily until clinical improvement, then initiate triazole therapy (eg, fluconazole or itraconazole) (HHS [OI adult 2016])

Cryptococcal disease

Cryptococcal disease:

CNS disease:

Non-HIV-exposed/-infected: Infant, Children, and Adolescents: IV: 0.7 to 1 mg/kg/dose once daily plus flucytosine; Note: Minimum 2- to 4-week induction, followed by consolidation and chronic suppressive therapy; may increase amphotericin dose to 1.5 mg/kg/day if flucytosine is not tolerated (IDSA [Perfect 2010])

HIV-exposed/-infected:

Infants and Children: IV: 1 mg/kg/dose once daily plus flucytosine or fluconazole; Note: Minimum 2-week induction, followed by consolidation and chronic suppressive therapy; a longer duration of induction therapy may be necessary if CSF is not negative or lack of clinical improvement; may increase amphotericin dose to 1.5 mg/kg/day alone or in combination with fluconazole if flucytosine is not tolerated (HHS [OI pediatric 2013])

Adolescents: IV: 0.7 to 1 mg/kg/dose once daily with or without flucytosine or fluconazole; Note: Minimum 2-week induction, followed by consolidation and chronic suppressive therapy (HHS [OI adult 2016])

Disseminated (non-CNS disease) or severe pulmonary disease: Independent of HIV status: Infants, Children, and Adolescents: IV: 0.7 to 1 mg/kg/dose once daily with or without flucytosine; duration of therapy depends on the site and severity of the infection and clinical response (HHS [OI adult 2016]; HHS [OI pediatric 2013]; IDSA [Perfect 2010])

Histoplasmosis

Histoplasmosis:

Non-HIV-exposed/-infected: Severe disseminated (non-CNS) or pulmonary disease: Infants, Children, and Adolescents: IV: 0.7 to 1 mg/kg/dose once daily; Note: Minimum 1- to 2-week induction, followed by consolidation therapy (IDSA [Wheat 2007])

HIV-exposed/-infected: CNS or severe disseminated disease: Infants and Children: IV: 0.7 to 1 mg/kg/dose once daily, followed by consolidation therapy (HHS [OI pediatric 2013])

Duration of induction:

Severe or moderately severe pulmonary disease: 1 to 2 week minimum

Disseminated or clinical improvement delayed: ≥2 weeks

CNS involvement: 4 to 6 weeks

Leishmaniasis, visceral, HIV-exposed/-infected

Leishmaniasis, visceral, HIV-exposed/-infected: Adolescents: IV: 0.5 to 1 mg/kg/dose once daily for a total cumulative dose of 1,500 to 2,000 mg (HHS [OI adult 2016])

Peritonitis

Peritonitis (CAPD): Limited data available: Note: Amphotericin B has demonstrated poor peritoneal penetration when given systemically and intraperitoneal administration is associated with abdominal pain and peritoneal irritation; other agents may be preferred (ISPD [Warady 2012]).

Intraperitoneal, dialysate: Infants, Children, and Adolescents: 1 to 4 mg per liter of dialysate has been used in pediatric patients based on case reports and retrospective reviews (Hogg 1982; Kravitz 1986; Raaijmakers 2007; Warady 2000a); lower doses of 0.5 to 3 mg per liter of dialysate has been reported in adults (with or without concomitant systemic amphotericin B therapy); abdominal pain has been associated with doses ≥2 mg per liter of dialysate (Bastani 1986; Johnson 1985).

IV: Infants, Children, and Adolescents: 1 mg/kg/dose once daily (ISPD [Warady 2000b])

Sporotrichosis, severe infection

Sporotrichosis, severe infection (IDSA [Kauffman 2007]): Children and Adolescents: 0.7 mg/kg/dose once daily; followed by oral itraconazole after a favorable response is seen with amphotericin initial therapy

Dosing: Kidney Impairment: Pediatric

Infants, Children, and Adolescents:

If renal dysfunction is due to the drug, the daily total can be decreased by 50% or the dose can be given every other day. IV therapy may take several months.

Renal replacement therapy: Poorly dialyzed; no supplemental dose or dosage adjustment necessary, including patients on intermittent hemodialysis or CRRT.

Dosing: Hepatic Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Older Adult

Refer to adult dosing.

Dosing: Obesity: Adult

The recommendations for dosing in patients with obesity are based upon the best available evidence and clinical expertise. Senior Editorial Team: Jeffrey F. Barletta, PharmD, FCCM; Manjunath P. Pai, PharmD, FCP; Jason A. Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC.

Class 1, 2, or 3 obesity (BMI ≥30 kg/m2): Note: Lipid-based formulations of amphotericin B are generally preferred for treatment of systemic infections because they demonstrate comparable efficacy and better tolerability (ECMM/MSG-ERC [Cornely 2019]; IDSA [Pappas 2016]; IDSA [Patterson 2016]; IDSA [Wheat 2007]).

IV: Use adjusted body weight for weight-based dose calculations (expert opinion). In more severe infections, may consider using actual body weight for weight-based dose calculations, although this may be associated with increased toxicity due to higher doses (Amsden 2011, expert opinion). When dosing with either adjusted or actual body weight, a maximum daily dose of 150 mg is suggested (extrapolated from a study of a similar product [Wasmann 2020, expert opinion]). Refer to "Dosing: Adult" for indication-specific doses.

Rationale for recommendations: There are sparse data describing the effect of obesity on dosing requirements for polyene antifungals (Amsden 2011). There are no human pharmacokinetic studies for amphotericin B deoxycholate in patients with obesity. Even though amphotericin B deoxycholate exhibits a Vd of 2.4 to 5.1 L/kg (Amsden 2011; Dupont 2002), distribution into adipose tissue appears to be limited; therefore, does not support routinely dosing based on actual body weight (Amsden 2011). Use adjusted body weight for weight-based dose calculations (expert opinion). For more severe infections, may consider using actual body weight for dose calculations (Amsden 2011; expert opinion).

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution Reconstituted, Intravenous, as deoxycholate [preservative free]:

Generic: 50 mg (1 ea)

Generic Equivalent Available: US

Yes

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution Reconstituted, Intravenous, as deoxycholate:

Fungizone IV: 50 mg (1 ea)

Administration: Adult

IV: May be infused over 2 to 6 hours; an inline filter (≥1 micron mean pore diameter) may be used for administration. To minimize infusion-related immediate reactions, premedicate with the following 30 to 60 minutes prior to drug administration: acetaminophen, diphenhydramine, and/or hydrocortisone. If the patient experiences rigors during the infusion, meperidine may be administered (HHS [OI adult] 2022; Sharkey 1996; manufacturer’s labeling). Preinfusion administration of 1 L of NS appears to reduce the risk of nephrotoxicity during treatment (HHS [OI adult] 2022).

Intraocular (off-label route): Administer amphotericin intravitreally or intracamerally with the dose in a final volume in 0.1 mL (Durand 2022a; Durand 2022b; Durand 2022c; IDSA [Pappas 2016]; IDSA [Patterson 2016]).

Intraventricular (off-label route): Use preservative-free preparations only. When administered through a ventricular drain, clamp drain for 15 to 60 minutes before opening the drain to allow amphotericin B solution to equilibrate in the CSF (IDSA [Tunkel 2017])

Irrigation (off-label route): A solution for irrigation (final concentration range: 0.05 to 0.25 mg/mL) may be administered via nephrostomy tubes for fungal balls associated with urinary tract infection due to candida. A solution for irrigation (final concentration: 0.05 mg/mL solution) may be instilled via bladder irrigation for cystitis (IDSA [Pappas 2016]).

Vaginal (off- label route): Administer intravaginal cream at bedtime, using an appropriately sized intravaginal applicator to deliver the correct dose (Sivasubramanian 2009; White 2001).

Administration: Pediatric

IV: Administer by IV infusion over 2 to 6 hours; an in-line filter (>1 micron mean pore diameter) may be used for administration (Kintzel 1992). For a patient who experiences chills, fever, hypotension, nausea, or other nonanaphylactic infusion-related reactions, premedicate with the following drugs 30 to 60 minutes prior to drug administration: A nonsteroidal (eg, ibuprofen) ± diphenhydramine or acetaminophen with diphenhydramine or hydrocortisone. If the patient experiences rigors during the infusion, meperidine may be administered. Bolus infusion of normal saline immediately preceding, or immediately preceding and following amphotericin B may reduce drug-induced nephrotoxicity. Risk of nephrotoxicity increases with amphotericin B doses >1 mg/kg/day.

Irrigation solution (bladder): Administer as a continuous irrigation or intermittently with a dwell time of 60 to 90 minutes (Fisher 2011; Gubbins 1999; Ku 2004; Martinez-Pajares 2010).

Intranasal: Administer intranasally via a De Vilbiss atomizer (Jeffrey 1991)

Use: Labeled Indications

Fungal infection, invasive: Treatment of patients with progressive, potentially life-threatening fungal infections: Aspergillosis, cryptococcosis, North American blastomycosis, systemic candidiasis, coccidioidomycosis, histoplasmosis, zygomycosis (including mucormycosis due to susceptible species of the genera Absidia, Mucor, and Rhizopus), and infections due to related susceptible species of Conidiobolus, Basidiobolus, and sporotrichosis.

Leishmaniasis: Alternative treatment in patients with American (New World) mucocutaneous leishmaniasis

Use: Off-Label: Adult

Candidiasis, esophageal, refractory disease; Candidiasis, oropharyngeal, refractory disease (oral); Candidiasis, urinary tract; Candidiasis, vulvovaginal, caused by C. glabrata; Leishmaniasis, visceral; Talaromycosis (formerly penicilliosis)

Medication Safety Issues
High alert medication:

The Institute for Safe Medication Practices (ISMP) includes this medication among its list of drugs which have a heightened risk of causing significant patient harm when used in error.

Sound-alike/look-alike issues:

Amphotericin B may be confused with amphotericin B liposomal

Other safety concerns:

Conventional amphotericin formulations (deoxycholate [Amphocin, Fungizone]) may be confused with lipid-based formulations (AmBisome, Abelcet, Amphotec).

Large overdoses have occurred when conventional formulations were dispensed inadvertently for lipid-based products. Single daily doses of amphotericin B deoxycholate should not exceed 1.5 mg/kg.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

Systemic:

Frequency not defined:

Cardiovascular: Hypotension

Endocrine & metabolic: Hypokalemia, weight loss

Gastrointestinal: Anorexia, diarrhea, dyspepsia, epigastric pain, nausea, stomach cramps, vomiting

Genitourinary: Azotemia

Hematologic & oncologic: Normocytic anemia (normochromic)

Local: Pain at injection site (with or without phlebitis or thrombophlebitis)

Nervous system: Chills, headache, malaise, pain

Neuromuscular & skeletal: Arthralgia, myalgia

Renal: Calcium nephrolithiasis, decreased urine specific gravity (hyposthenuria), renal insufficiency, renal tubular acidosis

Respiratory: Tachypnea

Miscellaneous: Fever

Postmarketing:

Cardiovascular: Cardiac arrhythmia, flushing, heart failure, hypertension, shock, ventricular fibrillation

Dermatologic: Maculopapular rash, pruritus, skin rash

Endocrine & metabolic: Hyperkalemia, hypocalcemia, hypomagnesemia

Gastrointestinal: Hemorrhagic gastroenteritis, melena

Genitourinary: Anuria, oliguria

Hematologic & oncologic: Agranulocytosis, disorder of hemostatic components of blood, eosinophilia, leukocytosis, leukopenia, thrombocytopenia

Hepatic: Acute hepatic failure, hepatitis, increased serum alanine aminotransferase, increased serum alkaline phosphatase, increased serum aspartate aminotransferase, increased serum bilirubin, jaundice

Hypersensitivity: Hypersensitivity reactions, nonimmune anaphylaxis

Nervous system: Encephalopathy, leukoencephalopathy, peripheral neuropathy, seizure, vertigo (transient)

Ophthalmic: Diplopia, visual disturbance

Otic: Hearing loss, tinnitus

Renal: Acute kidney injury, increased blood urea nitrogen, increased serum creatinine

Respiratory: Bronchospasm, dyspnea, hypersensitivity pneumonitis, pulmonary edema, wheezing

Contraindications

Hypersensitivity to amphotericin or any component of the formulation

Warnings/Precautions

Concerns related to adverse effects:

• Anaphylaxis: Has been reported with amphotericin B-containing drugs; facilities for cardiopulmonary resuscitation should be available during administration due to the possibility of anaphylactic reaction. If severe respiratory distress occurs, the infusion should be immediately discontinued; during the initial dosing, the drug should be administered under close clinical observation.

• Infusion reactions: Acute reactions (eg, fever, rigors, hypotension, anorexia, nausea, vomiting, headache, tachypnea) may occur 1 to 3 hours after starting an intravenous infusion. These reactions are usually more common with the first few doses and generally diminish with subsequent doses. Avoid rapid infusion to prevent hypotension, hypokalemia, arrhythmias, and shock.

• Leukoencephalopathy: Has been reported following administration of amphotericin B. Total body irradiation has been reported to be a possible predisposition.

• Nephrotoxicity: May cause nephrotoxicity; risk factors include underlying renal disease, concomitant nephrotoxic medications and daily and/or cumulative dosing of amphotericin. Avoid use with other nephrotoxic drugs; drug-induced renal toxicity usually improves with interrupting therapy, decreasing dosage, or increasing dosing interval. However permanent impairment may occur, especially in patients receiving a large cumulative dose (eg, >5 g) and in those also receiving other nephrotoxic drugs. Hydration and sodium repletion prior to administration may reduce the risk of developing nephrotoxicity. Frequent monitoring of renal function is recommended.

Disease-related concerns:

• Heart failure: In a scientific statement from the American Heart Association, amphotericin has been determined to be an agent that may cause direct myocardial toxicity (magnitude: moderate/major) (AHA [Page 2016]).

• Renal impairment: Use with caution in patients with renal impairment.

Special populations:

• Patients with neutropenia: Pulmonary reactions may occur in patients with neutropenia receiving leukocyte transfusions; separation of the infusions as much as possible is advised.

Other warnings/precautions:

• Therapy interruption: If therapy is stopped for >7 days, restart at the lowest dose recommended and increase gradually.

Warnings: Additional Pediatric Considerations

May premedicate patients who experience mild adverse reactions with acetaminophen and diphenhydramine 30 minutes prior to the amphotericin B infusion; meperidine and ibuprofen may help to reduce fevers and chills; hydrocortisone can be added to the infusion solution to reduce febrile and other systemic reactions. If therapy is stopped for >7 days, restart at the lowest dose recommended and increase gradually. Administer by slow IV infusion; rapid infusion has been associated with hypotension, hypokalemia, arrhythmias, and shock. Avoid extravasation; may cause chemical irritation; monitor infusion site; heparin 1 unit/1 mL of infusion solution can be added to reduce phlebitis. Use caution with intraperitoneal administration; use associated with irritation to the peritoneum and abdominal pain; not routinely used unless intolerance to other therapies (ISPD [Warady 2000b]).

Metabolism/Transport Effects

None known.

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.

Alfuzosin: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Amifostine: Blood Pressure Lowering Agents may enhance the hypotensive effect of Amifostine. Management: When used at chemotherapy doses, hold blood pressure lowering medications for 24 hours before amifostine administration. If blood pressure lowering therapy cannot be held, do not administer amifostine. Use caution with radiotherapy doses of amifostine. Risk D: Consider therapy modification

Aminoglycosides: Amphotericin B may enhance the nephrotoxic effect of Aminoglycosides. Amphotericin B may enhance the neurotoxic effect of Aminoglycosides. Risk C: Monitor therapy

Amisulpride (Oral): May enhance the hypotensive effect of Hypotension-Associated Agents. Risk C: Monitor therapy

Antifungal Agents (Azole Derivatives, Systemic): May diminish the therapeutic effect of Amphotericin B. Risk C: Monitor therapy

Antipsychotic Agents (Second Generation [Atypical]): Blood Pressure Lowering Agents may enhance the hypotensive effect of Antipsychotic Agents (Second Generation [Atypical]). Risk C: Monitor therapy

Arsenic Trioxide: Amphotericin B may enhance the hypotensive effect of Arsenic Trioxide. Amphotericin B may enhance the QTc-prolonging effect of Arsenic Trioxide. Management: When possible, avoid concurrent use of arsenic trioxide with drugs that can cause electrolyte abnormalities, such as amphotericin B. Risk D: Consider therapy modification

Barbiturates: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Benperidol: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Blood Pressure Lowering Agents: May enhance the hypotensive effect of Hypotension-Associated Agents. Risk C: Monitor therapy

Brimonidine (Topical): May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Bromperidol: May diminish the hypotensive effect of Blood Pressure Lowering Agents. Blood Pressure Lowering Agents may enhance the hypotensive effect of Bromperidol. Risk X: Avoid combination

Cardiac Glycosides: Amphotericin B may enhance the adverse/toxic effect of Cardiac Glycosides. Risk C: Monitor therapy

Colistimethate: Amphotericin B may enhance the nephrotoxic effect of Colistimethate. Management: Avoid coadministration of colistimethate and amphotericin B whenever possible due to the potential for additive or synergistic nephrotoxicity. If coadministration cannot be avoided, closely monitor renal function. Risk D: Consider therapy modification

Corticosteroids (Systemic): May enhance the hypokalemic effect of Amphotericin B. Risk C: Monitor therapy

CycloSPORINE (Systemic): Amphotericin B may enhance the nephrotoxic effect of CycloSPORINE (Systemic). Amphotericin B may increase the serum concentration of CycloSPORINE (Systemic). Risk C: Monitor therapy

Diazoxide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Dichlorphenamide: Amphotericin B may enhance the hypokalemic effect of Dichlorphenamide. Risk C: Monitor therapy

Dronabinol: May increase the serum concentration of Amphotericin B. Specifically, dronabinol may displace amphotericin B from its protein-binding sites, leading to an increased concentration of active, unbound drug. Risk C: Monitor therapy

DULoxetine: Blood Pressure Lowering Agents may enhance the hypotensive effect of DULoxetine. Risk C: Monitor therapy

Flucytosine: Amphotericin B may enhance the adverse/toxic effect of Flucytosine. Amphotericin B may increase the serum concentration of Flucytosine. Risk C: Monitor therapy

Foscarnet: May enhance the nephrotoxic effect of Amphotericin B. Risk X: Avoid combination

Ganciclovir-Valganciclovir: May enhance the nephrotoxic effect of Amphotericin B. Risk C: Monitor therapy

Herbal Products with Blood Pressure Lowering Effects: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Hypotension-Associated Agents: Blood Pressure Lowering Agents may enhance the hypotensive effect of Hypotension-Associated Agents. Risk C: Monitor therapy

Levodopa-Containing Products: Blood Pressure Lowering Agents may enhance the hypotensive effect of Levodopa-Containing Products. Risk C: Monitor therapy

Lormetazepam: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Methoxyflurane: May enhance the nephrotoxic effect of Amphotericin B. Risk X: Avoid combination

Molsidomine: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Naftopidil: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Nicergoline: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Nicorandil: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Nitroprusside: Blood Pressure Lowering Agents may enhance the hypotensive effect of Nitroprusside. Risk C: Monitor therapy

Obinutuzumab: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Management: Consider temporarily withholding blood pressure lowering medications beginning 12 hours prior to obinutuzumab infusion and continuing until 1 hour after the end of the infusion. Risk D: Consider therapy modification

Pentoxifylline: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Pholcodine: Blood Pressure Lowering Agents may enhance the hypotensive effect of Pholcodine. Risk C: Monitor therapy

Phosphodiesterase 5 Inhibitors: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Prostacyclin Analogues: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Quinagolide: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Risk C: Monitor therapy

Saccharomyces boulardii: Antifungal Agents (Systemic, Oral) may diminish the therapeutic effect of Saccharomyces boulardii. Risk X: Avoid combination

Pregnancy Considerations

Amphotericin crosses the placenta and enters the fetal circulation. Amphotericin B is recommended for the treatment of serious systemic fungal diseases in pregnant women. Refer to current guidelines (IDSA [Pappas 2016]; King 1998; Pilmis 2015).

Breastfeeding Considerations

It is not known if amphotericin is excreted into breast milk. Due to its poor oral absorption, systemic exposure to the nursing infant is expected to be decreased; however, because of the potential for toxicity, breast-feeding is not recommended by the manufacturer (Mactal-Haaf 2001).

Monitoring Parameters

BUN and serum creatinine levels should be determined every other day when therapy is increased and at least weekly thereafter. Renal function (monitor frequently during therapy), electrolytes (especially potassium and magnesium), LFTs, temperature, PT/PTT, CBC; fluid input and output; signs of hypokalemia (muscle weakness, cramping, drowsiness, ECG changes, etc); signs/symptoms of infusion-related reaction (fever, shaking chills, hypotension, anorexia, nausea, vomiting, headache, tachypnea).

Mechanism of Action

Binds to ergosterol altering cell membrane permeability in susceptible fungi and causing leakage of cell components with subsequent cell death. Proposed mechanism suggests that amphotericin causes an oxidation-dependent stimulation of macrophages (Lyman 1992).

Pharmacokinetics

Absorption: Poor oral absorption

Distribution: Minimal amounts enter the aqueous humor, bile, pericardial fluid, pleural fluid, and synovial fluid

CNS penetration:

Preterm neonates (GA: 27.4 ± 5 weeks): High interpatient variability; 40% to 90% of serum concentrations (Baley 1990)

Adults: Poor (inflamed or noninflamed meninges)

Vd: Pediatric patients (0 to 18 years): Highly variable; reported range: 0.38 to 3.99 L/kg (Benson 1989; Koren 1988)

Protein binding, plasma: 90%

Half-life elimination:

Premature neonates (GA: 27.4 ± 5 weeks): 14.8 hours (range: 5 to 82 hours) (Baley 1990)

Infants and Children (4 months to 14 years): 18.1 ± 6.6 hours (range: 11.9 to 40.3 hours) (Benson 1989)

Adults: Biphasic: Initial: 15 to 48 hours; Terminal: 15 days

Time to peak: Within 1 hour following a 4- to 6-hour dose

Excretion: Urine (2% to 5% as biologically active form); ~40% eliminated over a 7-day period and may be detected in urine for at least 7 weeks after discontinued use

Clearance (Benson, 1989):

Infants and Children (8 months to 9 years): 0.57 ± 0.152 mL/minute/kg

Children and Adolescents (10 to 14 years): 0.24 ± 0.02 mL/minute/kg

Pricing: US

Solution (reconstituted) (Amphotericin B Intravenous)

50 mg (per each): $54.63

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Brand Names: International
  • Amfucin (PH);
  • Ampho-Moronal (CH);
  • Amphocil (MX);
  • Ampholin (TH);
  • Ampholip (PH);
  • Amphotret (PH, ZW);
  • Anfotericina B (DO, GT, PA);
  • Fungilin (QA);
  • Fungilin Lozenges (AU, NZ);
  • Fungitericin (PH);
  • Fungizon (CN, HN);
  • Fungizona (ES);
  • Fungizone (CH, CO, DE, DK, FI, FR, GB, GR, HK, HU, IE, IN, IT, JO, KE, KR, NG, NL, PE, PL, PT, QA, SE, SI, TR, TW, TZ, UY, VE, VN, ZA);
  • Photericin B (EG);
  • Tericin (BD);
  • Terix (MX)


For country code abbreviations (show table)
  1. American Academy of Pediatrics (AAP). In: Kimberlin DW, Brady MT, Jackson MA, Long SA, eds. Red Book: 2015 Report of the Committee on Infectious Diseases. 30th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2015.
  2. Amphotericin B [prescribing information]. Big Flats, NY: X-Gen Pharmaceuticals; April 2010.
  3. Amsden JR, Slain D. Antifungal dosing in obesity: a review of the literature. Curr Fungal Infect Rep. 2011;5:83-91. doi:10.1007/s12281-011-0049-7
  4. Aronson N, Herwaldt BL, Libman M, et al. Diagnosis and treatment of Leishmaniasis: clinical practice guidelines by the Infectious Diseases Society of America (IDSA) and the American Society of Tropical Medicine and Hygiene (ASTMH). Clin Infect Dis. 2016;63(12):1539-1557. doi:10.1093/cid/ciw742 [PubMed 27941143]
  5. Arsura EL, Ismail Y, Freedman S, et al, “Amphotericin B-Induced Dilated Cardiomyopathy,” Am J Med, 1994, 97(6):560-2. [PubMed 7985716]
  6. Aydin S, Ertugrul B, Gultekin B, Uyar G, Kir E. Treatment of two postoperative endophthalmitis cases due to Aspergillus flavus and Scopulariopsis spp. with local and systemic antifungal therapy. BMC Infect Dis. 2007;7:87. [PubMed 17672897]
  7. Baddley JW. Treatment of histoplasmosis in patients with HIV. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. https://www.uptodate.com. Accessed March 14, 2022.
  8. Baddley JW, Forrest GN; AST Infectious Diseases Community of Practice. Cryptococcosis in solid organ transplantation-Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant. 2019;33(9):e13543. doi:10.1111/ctr.13543 [PubMed 30900315]
  9. Baley JE, Meyers C, Kliegman RM, et al, "Pharmacokinetics, Outcome of Treatment, and Toxic Effects of Amphotericin B and 5-Fluorocytosine in Neonates," J Pediatr, 1990, 116(5):791-7.
  10. Baltimore RS, Gewitz M, Baddour LM, et al; American Heart Association Rheumatic Fever, Endocarditis; Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young and the Council on Cardiovascular and Stroke Nursing. Infective endocarditis in childhood: 2015 update: a scientific statement from the American Heart Association. Circulation. 2015;132(15):1487-1515. doi: 10.1161/CIR.0000000000000298 [PubMed 26373317]
  11. Bastani B, Westervelt FB Jr. Persistence of Candida despite seemingly adequate systemic and intraperitoneal amphotericin B treatment in a patient on CAPD. Am J Kidney Dis. 1986;8(4):265-266. [PubMed 3766532]
  12. Bellmann R, Egger P, Gritsch W, et al. Amphotericin B lipid formulations in critically ill patients on continuous veno-venous haemofiltration. J Antimicrob Chemother. 2003;51(3):671-681. doi:10.1093/jac/dkg139 [PubMed 12615870]
  13. Benson JM and Nahata MC, “Clinical Use of Systemic Antifungal Agents,” Clin Pharm, 1988, 7(6):424-38. [PubMed 3042267]
  14. Benson JM and Nahata MC, “Pharmacokinetics of Amphotericin B in Children,” Antimicrob Agents Chemother, 1989, 33(11):1989-93. [PubMed 2610508]
  15. Bilbao-Meseguer I, Rodríguez-Gascón A, Barrasa H, Isla A, Solinís MÁ. Augmented renal clearance in critically ill patients: a systematic review. Clin Pharmacokinet. 2018;57(9):1107-1121. doi:10.1007/s40262-018-0636-7 [PubMed 29441476]
  16. Bradley JS, Nelson JD, Barnett E, et al. Nelson's Pediatric Antimicrobial Therapy. 22nd ed. American Academy of Pediatrics; 2016.
  17. Branch RA, “Prevention of Amphotericin B-Induced Renal Impairment. A Review on the Use of Sodium Supplementation,” Arch Intern Med, 1988, 148(11):2389-94. [PubMed 3056312]
  18. Burch PA, Karp JE, Merz WG, Kuhlman JE, Fishman EK. Favorable outcome of invasive aspergillosis in patients with acute leukemia. J Clin Oncol. 1987;5(12):1985-1993. doi:10.1200/JCO.1987.5.12.1985 [PubMed 3681380]
  19. Candidiasis (Mucocutaneous). In: US Department of Health and Human Services (HHS) Panel on Opportunistic Infections in Adults and Adolescents with HIV. Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV: recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. https://clinicalinfo.hiv.gov/sites/default/files/guidelines/documents/Adult_OI.pdf. Updated May 26, 2020. Accessed June 16, 2021.
  20. Chakrabarti A, Shivaprakash MR, Singh R, et al. Fungal endophthalmitis: fourteen years' experience from a center in India. Retina. 2008;28(10):1400-1407. doi:10.1097/iae.0b013e318185e943 [PubMed 19009680]
  21. Challenor R, Pinsent S, Ekanayaka R. A case series of the management of symptomatic azole-resistant candida. Int J STD AIDS. 2012;23(5):375-376. doi:10.1258/ijsa.2009.009441 [PubMed 22648899]
  22. Chapman SW, Dismukes WE, Proia LA, et al. Clinical practice guidelines for the management of blastomycosis: 2008 update by the Infectious Diseases Society of America. Clin Infect Dis. 2008;46(12):1801-1812. [PubMed 18462107]
  23. Chiou CC, Wong TT, Lin HH, et al, "Fungal Infection of Ventriculoperitoneal Shunts in Children," Clin Infect Dis, 1994, 19(6):1049-53. [PubMed 7888533]
  24. Cornely OA, Alastruey-Izquierdo A, Arenz D, et al; Mucormycosis ECMM MSG Global Guideline Writing Group. Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium. Lancet Infect Dis. 2019;19(12):e405-e421. doi:10.1016/S1473-3099(19)30312-3 [PubMed 31699664]
  25. Cruz JM, Peacock JE Jr, Loomer L, et al, “Rapid Intravenous Infusion of Amphotericin B: A Pilot Study,” Am J Med, 1992, 93:123-30. [PubMed 1497007]
  26. Devuyst O, Goffin E, and Van Ypersele de Strihou C, “Recurrent Hemiparesis Under Amphotericin B for Candida albicans Peritonitis,” Nephrol Dial Transplant, 1995, 10(5):699-701. [PubMed 7566587]
  27. Dupont B. Overview of the lipid formulations of amphotericin B. J Antimicrob Chemother. 2002;49(suppl 1):S31-S36. doi:10.1093/jac/49.suppl_1.31 [PubMed 11801578]
  28. Durand ML, Kauffman CA. Treatment of endogenous endophthalmitis due to Candida species. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. https://www.uptodate.com. Accessed March 10, 2022b.
  29. Durand ML, Kauffman CA. Treatment of endophthalmitis due to molds. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. https://www.uptodate.com. Accessed March 10, 2022a.
  30. Durand ML, Kauffman CA. Treatment of exogenous endophthalmitis due to Candida species. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. https://www.uptodate.com. Accessed March 10, 2022c.
  31. Eriksson U, Seifert B, and Schaffner A, "Comparison of Effects of Amphotericin B Deoxycholate Infused Over 4 or 24 Hours: Randomised Controlled Trial," BMJ, 2001, 322(7286):579-82. [PubMed 11238151]
  32. Falagas ME, Karageorgopoulos DE, Tansarli GS. Continuous versus conventional infusion of amphotericin B deoxycholate: a meta-analysis. PLoS One. 2013;8(10):e77075. doi:10.1371/journal.pone.0077075 [PubMed 24204739]
  33. Fichtenbaum CJ, Zackin R, Rajicic N, Powderly WG, Wheat LJ, Zingman BS. Amphotericin B oral suspension for fluconazole-refractory oral candidiasis in persons with HIV infection. Adult AIDS Clinical Trials Group Study Team 295. AIDS. 2000;14(7):845-852. doi:10.1097/00002030-200005050-00011 [PubMed 10839593]
  34. Fisher JF, Sobel JD, Kauffman CA, et al. Candida urinary tract infections – treatment. Clin Infect Dis. 2011;52(Suppl 6):S457-S466. [PubMed 21498839]
  35. Gales MA and Gales BJ, “Rapid Infusion of Amphotericin B in Dextrose,” Ann Pharmacother, 1995, 29(5):523-9. [PubMed 7655137]
  36. Galgiani JN, Ampel NM, Blair JE, et al; Infectious Diseases Society of America. Coccidioidomycosis. Clin Infect Dis. 2005;41(9):1217-1223. doi: 10.1086/496991. [PubMed 16206093]
  37. Galgiani JN, Ampel NM, Blair JE, et al. 2016 Infectious Diseases Society of America (IDSA) clinical practice guideline for the treatment of coccidioidomycosis. Clin Infect Dis. 2016;63(6):e112-e146. doi:10.1093/cid/ciw360 [PubMed 27470238]
  38. Gallis HA, Drew RH, and Pickard WW, “Amphotericin B: 30 Years of Clinical Experience,” Rev Infect Dis, 1990, 12(2):308-29. [PubMed 2184499]
  39. Goodwin SD, Cleary JD, Walawander CA, et al, “Pretreatment Regimens for Adverse Events Related to Infusion of Amphotericin B,” Clin Infect Dis, 1995, 20(4):755-61. [PubMed 7795069]
  40. Gould FK, Denning DW, Elliott TS, et al, “Guidelines for the Diagnosis and Antibiotic Treatment of Endocarditis in Adults: A Report of the Working Party of the British Society for Antimicrobial Chemotherapy,” J Antimicrob Chemother, 2012, 67(2):269-89. [PubMed 22086858]
  41. Gubbins PO, McConnell SA, and Penzak SR, "Current Management of Funguria," Am J Health Syst Pharm, 1999, 56(19):1929-35. [PubMed 10554910]
  42. Gussak HM, Rahman S, Bastani B. Administration and clearance of amphotericin B during high-efficiency or high-efficiency/high-flux dialysis. Am J Kidney Dis. 2001;37(6):E45. doi:10.1053/ajkd.2001.24545 [PubMed 11382716]
  43. Harbarth S, Pestotnik SL, Lloyd JF, et al, "The Epidemiology of Nephrotoxicity Associated With Conventional Amphotericin B Therapy," Am J Med, 2001, 111(7):528-34. [PubMed 11705428]
  44. Heintz BH, Matzke GR, Dager WE. Antimicrobial dosing concepts and recommendations for critically ill adult patients receiving continuous renal replacement therapy or intermittent hemodialysis. Pharmacotherapy. 2009;29(5):562-577. doi:10.1592/phco.29.5.562 [PubMed 19397464]
  45. Herbrecht R, Denning DW, Patterson TF, et al; Invasive Fungal Infections Group of the European Organisation for Research and Treatment of Cancer and the Global Aspergillus Study Group. Voriconazole versus amphotericin B for primary therapy of invasive aspergillosis. N Engl J Med. 2002;347(6):408-415. doi:10.1056/NEJMoa020191 [PubMed 12167683]
  46. Hettiarachchi N, Ashbee HR, Wilson JD. Prevalence and management of non-albicans vaginal candidiasis. Sex Transm Infect. 2010;86(2):99-100. doi:10.1136/sti.2009.040386 [PubMed 20332368]
  47. HHS. Guidelines for the prevention and treatment of opportunistic infections among HIV-exposed and HIV-infected children: recommendations from the National Institutes of Health, Centers for Disease Control and Prevention, the HIV Medicine Association of the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the American Academy of Pediatrics. November 6, 2013. Available at http://aidsinfo.nih.gov
  48. Hoenigl M, Krause R. Antifungal therapy of aspergillosis of the central nervous system and aspergillus endophthalmitis. Curr Pharm Des.2013;19(20):3648-3668. [PubMed 23278539]
  49. Hogg RJ, Arant BS Jr, Houser MT. Candida peritonitis in children on continuous ambulatory peritoneal dialysis. Int J Pediatr Nephrol. 1982;3(4):287-291. [PubMed 6299987]
  50. Imhof A, Walter RB, and Schaffner A, "Continuous Infusion of Escalated Doses of Amphotericin B Deoxycholate: An Open-Label Observational Study," Clin Infect Dis, 2003, 36(8):943-51. [PubMed 12684904]
  51. Jeffery GM, Beard ME, Ikram RB, et al, “Intranasal Amphotericin B Reduces the Frequency of Invasive Aspergillosis in Neutropenic Patients,” Am J Med, 1991, 90(6):685-92. [PubMed 2042684]
  52. Johnson PC, Wheat LJ, Cloud GA, et al; U.S. National Institute of Allergy and Infectious Diseases Mycoses Study Group. Safety and efficacy of liposomal amphotericin B compared with conventional amphotericin B for induction therapy of histoplasmosis in patients with AIDS. Ann Intern Med. 2002;137(2):105-109. doi:10.7326/0003-4819-137-2-200207160-00008 [PubMed 12118965]
  53. Johnson RJ, Ramsey PG, Gallagher N, Ahmad S. Fungal peritonitis in patients on peritoneal dialysis: incidence, clinical features and prognosis. Am J Nephrol. 1985;5(3):169-175. [PubMed 4014323]
  54. Jones RS, Barman A, Suh B, et al, “Successful Treatment of Aspergillus vertebral Osteomyelitis With Amphotericin B Lipid Complex,” Infect Dis Clin Pract, 1995, 4:237-9.
  55. Kauffman CA, Bustamante B, Chapman SW, Pappas PG, Infectious Diseases Society of America. Clinical practice guidelines for the management of sporotrichosis: 2007 update by the Infectious Diseases Society of America. Clin Infect Dis. 2007;45(10):1255-1265. [PubMed 17968818]
  56. Kauffman CA. Esophageal candidiasis in adults. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. https://www.uptodate.com. Accessed September 23, 2021a.
  57. Kauffman CA. Oropharyngeal candidiasis in adults. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. https://www.uptodate.com. Accessed June 17, 2021b.
  58. Kaushik S, Ram J, Brar GS, Jain AK, Chakraborti A, Gupta A. Intracameral amphotericin B: initial experience in severe keratomycosis. Cornea. 2001;20(7):715-719. [PubMed 11588423]
  59. King CT, Rogers PD, Cleary JD, et al, "Antifungal Therapy During Pregnancy," Clin Infect Dis, 1998, 27(5):1151-60. [PubMed 9827262]
  60. Kintzel PE and Smith GH, “Practical Guidelines for Preparing and Administering Amphotericin B,” Am J Hosp Pharm, 1992, 49(5):1156-64. [PubMed 1595747]
  61. Klaus JR, Knodel LC, and Kavanagh RE, "Administration Guidelines for Parenteral Drug Therapy. Part I: Pediatric Patients," J Pharm Technol, 1989, 5(3):101-28. [PubMed 10318297]
  62. Koren G, Lau A, Klein J, et al, “Pharmacokinetics and Adverse Effects of Amphotericin B in Infants and Children,” J Pediatr, 1988, 113(3):559-63. [PubMed 3411404]
  63. Kravitz SP, Berry PL. Successful treatment of Aspergillus peritonitis in a child undergoing continuous cycling peritoneal dialysis. Arch Intern Med. 1986;146(10):2061-2062. [PubMed 3767552]
  64. Ku JH, Kim ME, Jeon YS, et al, "Urinary Ascites and Anuria Caused by Bilateral Fungal Balls in a Premature Infant," Arch Dis Child Fetal Neonatal Ed, 2004, 89(1):F92-3. [PubMed 14711869]
  65. Kuriakose T, Kothari M, Paul P, Jacob P, Thomas R. Intracameral amphotericin B injection in the management of deep keratomycosis. Cornea. 2002;21(7):653-656. doi:10.1097/00003226-200210000-00004 [PubMed 12352080]
  66. Li PK, Szeto CC, Piraino B, et al. ISPD peritonitis recommendations: 2016 update on prevention and treatment. Perit Dial Int. 2016;36(5):481-508. doi:10.3747/pdi.2016.00078 [PubMed 27282851]
  67. Llanos A, Cieza J, Bernardo J, et al. Effect of salt supplementation on amphotericin B nephrotoxicity. Kidney Int. 1991;40(2):302-308. doi:10.1038/ki.1991.214 [PubMed 1942779]
  68. Lyman CA and Walsh TJ, “Systemically Administered Antifungal Agents. A Review of Their Clinical Pharmacology and Therapeutic Applications,” Drugs, 1992, 44(1):9-35. [PubMed 1379913]
  69. Mactal-Haaf C, Hoffman M, and Kuchta A, "Use of Anti-infective Agents During Lactation, Part 3: Antivirals, Antifungals, and Urinary Antiseptics," J Hum Lact, 2001, 17(2):160-6. [PubMed 11847833]
  70. Maddux MS, Barriere SL. A review of complications of amphotericin-B therapy: recommendations for prevention and management. Drug Intelligence & Clinical Pharmacy. 1980;14(3):177-181. doi:10.1177/106002808001400303
  71. Martinez-Pajares JD, Martinez-Ferriz MC, Moreno-Perez D, et al, "Management of Obstructive Renal Failure Caused by Bilateral Renal Aspergilloma in an Immunocompetent Newborn," J Med Microbiol, 2010, 59(Pt 3):367-9. [PubMed 19910484]
  72. Mohr J, Johnson M, Cooper T, et al, “Current Options in Antifungal Pharmacotherapy,” Pharmacotherapy, 2008, 28(5):614-45. [PubMed 18447660]
  73. Murphy K, Bradley J, and James HE, "The Treatment of Candida albicans Shunt Infections," Childs Nerv Syst, 2000, 16(1):4-7. [PubMed 10672422]
  74. Nemecek BD, Hammond DA, eds. Demystifying Drug Dosing in Renal Dysfunction. American Society of Health-System Pharmacists; 2019.
  75. Nesbit SA, Ketz KE, McClain BW, et al. Comparison of two concentrations of amphotericin B bladder irrigation in the treatment of funguria in patients with indwelling urinary catheters. Am J Health Syst Pharm. 1999;56(9):872- 875. [PubMed 10344610]
  76. Page RL 2nd, O'Bryant CL, Cheng D, et al; American Heart Association Clinical Pharmacology and Heart Failure and Transplantation Committees of the Council on Clinical Cardiology; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular and Stroke Nursing; and Council on Quality of Care and Outcomes Research. Drugs That May Cause or Exacerbate Heart Failure: A Scientific Statement From the American Heart Association [published correction appears in Circulation. 2016;134(12):e261]. Circulation. 2016;134(6):e32-e69. [PubMed 27400984]
  77. Pappas PG, Kauffman CA, Andes DR, et al. Clinical practice guideline for the management of candidiasis: 2016 update by the Infectious Diseases Society of America. Clin Infect Dis. 2016;62(4):e1-e50. doi: 10.1093/cid/civ933. [PubMed 26679628]10.1093/cid/civ933
  78. Patel R, “Antifungal Agents. Part I. Amphotericin B Preparations and Flucytosine,” Mayo Clin Proc, 1998, 73(12):1205-25. [PubMed 9868423]
  79. Patterson TF, Thompson GR 3rd, Denning DW, et al. Practice guidelines for the diagnosis and management of aspergillosis: 2016 update by the Infectious Diseases Society of America. Clin Infect Dis. 2016;63(4):e1-e60. doi:10.1093/cid/ciw326 [PubMed 27365388]
  80. Peleg AY and Woods ML. Continuous and 4 h infusion of amphotericin B: a comparative study involving high-risk haematology patients. J Antimicrob Chemother. 2004;54(4):803-808. [PubMed 15308606]
  81. Perfect JR, Dismukes WE, Dromer F, et al. Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the Infectious Diseases Society of America. Clin Infect Dis. 2010;50(3):291-322. [PubMed 20047480]
  82. Pilmis B, Jullien V, Sobel J, et al. Antifungal drugs during pregnancy: an updated review. J Antimicrob Chemother. 2015;70(1):14-22. doi: 10.1093/jac/dku355. [PubMed 25204341]10.1093/jac/dku355
  83. Raaijmakers R, Schröder C, Monnens L, et al, "Fungal Peritonitis in Children on Peritoneal Dialysis," Pediatr Nephrol, 2007, 22(2):288-93. [PubMed 17111161]
  84. Rex JH, Bennett JE, Sugar AM, “A Randomized Trial Comparing Fluconazole With Amphotericin B for the Treatment of Candidemia in Patients Without Neutropenia. Candidemia Study Group and the National Institute,” N Engl J Med, 1994, 331(20):1325-30. [PubMed 7935701]
  85. Riddell J 4th, Comer GM, Kauffman CA. Treatment of endogenous fungal endophthalmitis: focus on new antifungal agents. Clin Infect Dis. 2011;52(5):648-653. doi: 10.1093/cid/ciq204. [PubMed 21239843]
  86. Ritterband D, Kelly J, McNamara T, Kresloff M, Koplin R, Seedor J. Delayed-onset multifocal polymicrobial keratitis after laser in situ keratomileusis. J Cataract Refract Surg. 2002;28(5):898-899. [PubMed 11978476]
  87. Rothenbühler C, Held U, Manz MG, Schanz U, Gerber B. Continuously infused amphotericin B deoxycholate for primary treatment of invasive fungal disease in acute myeloid leukaemia. Hematol Oncol. 2018;36(2):471-480. doi:10.1002/hon.2500 [PubMed 29431860]
  88. Sharkey PK, Graybill JR, Johnson ES, et al. Amphotericin B lipid complex compared with amphotericin B in the treatment of cryptococcal meningitis in patients with AIDS. Clin Infect Dis. 1996;22(2):315-321. [PubMed 8838189]
  89. Sinnollareddy M, Peake SL, Roberts MS, Lipman J, Roberts JA. Using pharmacokinetics and pharmacodynamics to optimise dosing of antifungal agents in critically ill patients: a systematic review. Int J Antimicrob Agents. 2012;39(1):1-10. doi:10.1016/j.ijantimicag.2011.07.013 [PubMed 21925845]
  90. Sivasubramanian G, Sobel JD. Refractory urinary tract and vulvovaginal infection caused by Candida krusei. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(11):1379-1381. doi:10.1007/s00192-009-0869-y [PubMed 19834757]
  91. Slain D, “Lipid-Based Amphotericin B for the Treatment of Fungal Infections,” Pharmacotherapy, 1999, 19(3):306-23. [PubMed 10221369]
  92. Sobel JD. Candida vulvovaginitis: treatment. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed October 27, 2021.
  93. Stevens DA and Shatsky SA, "Intrathecal Amphotericin in the Management of Coccidioidal Meningitis," Semin Respir Infect, 2001, 16(4):263-9. [PubMed 11740828]
  94. Taillandier J, Esnault Y, Alemanni M. A comparison of fluconazole oral suspension and amphotericin B oral suspension in older patients with oropharyngeal candidosis. Multicentre Study Group. Age Ageing. 2000;29(2):117-123. doi:10.1093/ageing/29.2.117 [PubMed 10791445]
  95. Tamcelik N, Ozdamar A, Kizilkaya M, Devranoglu K, Ustundag C, Demirkesen C. Fungal keratitis after nonpenetrating glaucoma surgery. Cornea. 2002;21(5):532-534. [PubMed 12072733]
  96. The Ad Hoc Advisory Panel on Peritonitis Management. “Continuous Ambulatory Peritoneal Dialysis (CAPD) Peritonitis Treatment Recommendations: 1989 Update,” Perit Dial Int, 1989, 9(4):247-56. [PubMed 2488376]
  97. Tunkel AR, Hasbun R, Bhimraj A, et al. 2017 Infectious Diseases Society of America's clinical practice guidelines for healthcare-associated ventriculitis and meningitis [published online February 14, 2017]. Clin Infect Dis. doi: 10.1093/cid/ciw861. [PubMed 28203777]
  98. Turcu R, Patterson MJ, and Omar S, "Influence of Sodium Intake on Amphotericin B-Induced Nephrotoxicity Among Extremely Premature Infants," Pediatr Nephrol, 2009, 24(3):497-505. [PubMed 19082636]
  99. Turkova A, Roilides E, Sharland M. Amphotericin B in neonates: deoxycholate or lipid formulation as first-line therapy - is there a 'right' choice? Curr Opin Infect Dis. 2011;24(2):163-171. [PubMed 21301335]
  100. Udy AA, Roberts JA, Boots RJ, Paterson DL, Lipman J. Augmented renal clearance: implications for antibacterial dosing in the critically ill. Clin Pharmacokinet. 2010;49(1):1-16. doi:10.2165/11318140-000000000-00000 [PubMed 20000886]
  101. US Department of Health and Human Services Panel on Opportunistic Infections in HIV-Exposed and HIV-Infected Children. Guidelines for the prevention and treatment of opportunistic infections among HIV-exposed and HIV-infected children: recommendations from the National Institutes of Health, Centers for Disease Control and Prevention, the HIV Medicine Association of the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the American Academy of Pediatrics. https://aidsinfo.nih.gov/contentfiles/lvguidelines/oi_guidelines_pediatrics.pdf. Accessed September 29, 2017.
  102. US Department of Health and Human Services (HHS) Panel on Opportunistic Infections in Adults and Adolescents with HIV. Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV: recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. http://aidsinfo.nih.gov/contentfiles/lvguidelines/adult_oi.pdf. Accessed August 23, 2021.
  103. US Department of Health and Human Services (HHS) Panel on Opportunistic Infections in Adults and Adolescents with HIV. Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV. https://clinicalinfo.hiv.gov/sites/default/files/guidelines/documents/Adult_OI.pdf. Updated January 12, 2022. Accessed March 2, 2022.
  104. Warady BA, Bakkaloglu S, Newland J, et al. Consensus guidelines for the prevention and treatment of catheter-related infections and peritonitis in pediatric patients receiving peritoneal dialysis: 2012 update. Perit Dial Int. 2012;32 Suppl 2:S32-86. [PubMed 22851742]
  105. Warady BA, Bashir M, Donaldson LA. Fungal peritonitis in children receiving peritoneal dialysis: a report of the NAPRTCS. Kidney Int. 2000a;58(1):384-389. [PubMed 10886585]
  106. Warady BA, Schaefer F, Holloway M, et al. Consensus guidelines for the treatment of peritonitis in pediatric patients receiving peritoneal dialysis. Perit Dial Int, 2000b;20(6):610-624. [PubMed 11216549]
  107. Wasmann RE, Smit C, van Dongen EPH, et al. Fixed dosing of liposomal amphotericin B in morbidly obese individuals. Clin Infect Dis. 2020;70(10):2213-2215. doi:10.1093/cid/ciz885 [PubMed 31588493]
  108. Wheat LJ, Freifeld AG, Kleiman MB, et al. Clinical practice guidelines for the management of patients with histoplasmosis: 2007 update by the Infectious Diseases Society of America. Clin Infect Dis. 2007;45(7):807-825. [PubMed 17806045]
  109. White DJ, Habib AR, Vanthuyne A, Langford S, Symonds M. Combined topical flucytosine and amphotericin B for refractory vaginal Candida glabrata infections. Sex Transm Infect. 2001;77(3):212-213. doi:10.1136/sti.77.3.212 [PubMed 11402233]
  110. World Health Organization (WHO). Guidelines for diagnosing, preventing and managing cryptococcal disease among adults, adolescents and children living with HIV. https://www.who.int/publications/i/item/9789240052178. Published June 2022.
  111. Wiest DB, Maish WA, Garner SS, el-Chaar GM. Stability of amphotericin B in four concentrations of dextrose injection. Am J Hosp Pharm. 1991;48(11):2430-2433. [PubMed 1746578]
  112. Yilmaz S, Ture M, Maden A. Efficacy of intracameral amphotericin B injection in the management of refractory keratomycosis and endophthalmitis. Cornea. 2007;26(4):398-402. [PubMed 17457185]
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