|
This information has been developed and provided by an independent third-party source. Merck & Co., Inc. does not endorse and is not responsible for the accuracy of the content, or for practices or
standards of non-Merck sources.
ALERT: U.S. Boxed Warning
The FDA-approved labeling includes a boxed warning. See Warnings/Precautions section for a concise summary of this information. For verbatim wording of the boxed warning, consult the product labeling or www.fda.gov.
Pronunciation
(am foe TER i sin bee con VEN sha nal)
Generic Available (U.S.)
Yes
Index Terms
Brand Names: Canada
Pharmacologic Category
Pharmacologic Category Synonyms
Use: Labeled Indications
Treatment of severe systemic and central nervous system infections caused by susceptible fungi such as Candida species, Histoplasma capsulatum, Cryptococcus neoformans, Aspergillus species, Blastomyces dermatitidis, Torulopsis glabrata, and Coccidioides immitis; fungal peritonitis; irrigant for bladder fungal infections; used in fungal infection in patients with bone marrow transplantation, amebic meningoencephalitis, ocular aspergillosis (intraocular injection), candidal cystitis (bladder irrigation), chemoprophylaxis (low-dose I.V.), immunocompromised patients at risk of aspergillosis (intranasal/nebulized), refractory meningitis (intrathecal), coccidioidal arthritis (intra-articular/I.M.).
Low-dose amphotericin B has been administered after bone marrow transplantation to reduce the risk of invasive fungal disease.
Pregnancy Risk Factor
B
Pregnancy Considerations
Adverse events were not observed in animal reproduction studies. Amphotericin crosses the placenta and enters the fetal circulation. No teratogenic or undue systemic toxicity (electrolyte imbalance or renal dysfunction) has been reported in the mother or fetus. Toxic maternal effects are to be expected and must be monitored (Perfect, 2010). Amphotericin B is recommended for the treatment of serious systemic fungal diseases in pregnant women. Refer to current guidelines (King, 1998).
Lactation
Excretion in breast milk unknown/not recommended
Breast-Feeding 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 (Mactal-Haaf, 2001).
Contraindications
Hypersensitivity to amphotericin or any component of the formulation
Warnings/Precautions
Boxed warnings:
• Error prevention: See “Other warnings/precautions” below.
• Fungal infections: See “Disease-related concerns” below.
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, shaking chills, hypotension, anorexia, nausea, vomiting, headache, tachypnea ) may occur 1-3 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. Total body irradiation has been reported to be a possible predisposition.
• Nephrotoxicity: May cause nephrotoxicity; usual 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 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:
• Fungal infections: [U.S. Boxed Warning]: Should be used primarily for treatment of progressive, potentially life-threatening fungal infections, not noninvasive forms of infection.
• Renal impairment: Use with caution in patients with renal impairment.
Special populations:
• Neutropenic patients: Pulmonary reactions may occur in neutropenic patients receiving leukocyte transfusions; separation of the infusions as much as possible is advised.
Other warnings/precautions:
• Error prevention: [U.S. Boxed warning]: Verify the product name and dosage if dose exceeds 1.5 mg/kg.
• Therapy interruption: If therapy is stopped for >7 days, restart at the lowest dose recommended and increase gradually.
Adverse Reactions
Systemic:
>10%:
Cardiovascular: Hypotension, tachypnea
Central nervous system: Fever, chills, headache (less frequent with I.T.), malaise
Endocrine & metabolic: Hypokalemia, hypomagnesemia
Gastrointestinal: Anorexia, nausea (less frequent with I.T.), vomiting (less frequent with I.T.), diarrhea, heartburn, cramping epigastric pain
Hematologic: Normochromic-normocytic anemia
Local: Pain at injection site with or without phlebitis or thrombophlebitis (incidence may increase with peripheral infusion of admixtures)
Neuromuscular & skeletal: Generalized pain, including muscle and joint pains (less frequent with I.T.)
Renal: Decreased renal function and renal function abnormalities including azotemia, renal tubular acidosis, nephrocalcinosis (>0.1 mg/mL)
1% to 10%:
Cardiovascular: Hypertension, flushing
Central nervous system: Delirium, arachnoiditis, pain along lumbar nerves (especially I.T. therapy)
Genitourinary: Urinary retention
Hematologic: Leukocytosis
Neuromuscular & skeletal: Paresthesia (especially with I.T. therapy)
<1% (Limited to important or life-threatening): Acute liver failure, agranulocytosis, anuria, arrhythmias, bone marrow suppression, bronchospasm, cardiac arrest, cardiac failure, coagulation defects, convulsions, diplopia, dyspnea, eosinophilia, hearing loss, hemorrhagic gastroenteritis, hepatitis, hypersensitivity pneumonitis, increased liver function tests, jaundice, leukoencephalopathy, leukopenia, maculopapular rash, melena, nephrogenic diabetes insipidus, oliguria, peripheral neuropathy, pruritus, pulmonary edema, renal failure, renal tubular acidosis, shock, skin exfoliation, Stevens-Johnson syndrome, thrombocytopenia, tinnitus, toxic epidermal necrolysis, transient vertigo, ventricular fibrillation, vision changes, wheezing
Metabolism/Transport Effects
None known.
Drug Interactions
Aminoglycosides: Amphotericin B may enhance the nephrotoxic effect of Aminoglycosides. Risk C: Monitor therapy
Antifungal Agents (Azole Derivatives, Systemic): May diminish the therapeutic effect of Amphotericin B. Risk C: Monitor therapy
Colistimethate: Amphotericin B may enhance the nephrotoxic effect of Colistimethate. Risk D: Consider therapy modification
Corticosteroids (Orally Inhaled): May enhance the hypokalemic effect of Amphotericin B. Risk C: Monitor therapy
Corticosteroids (Systemic): May enhance the hypokalemic effect of Amphotericin B. Risk C: Monitor therapy
CycloSPORINE: Amphotericin B may enhance the nephrotoxic effect of CycloSPORINE. Risk C: Monitor therapy
CycloSPORINE (Systemic): Amphotericin B may enhance the nephrotoxic effect of CycloSPORINE (Systemic). Risk C: Monitor therapy
Flucytosine: Amphotericin B may enhance the adverse/toxic effect of Flucytosine. This may be related to the adverse effects of amphotericin B on renal function. Risk C: Monitor therapy
Gallium Nitrate: Amphotericin B may enhance the nephrotoxic effect of Gallium Nitrate. Risk X: Avoid combination
Saccharomyces boulardii: Antifungal Agents may diminish the therapeutic effect of Saccharomyces boulardii. Risk D: Consider therapy modification
Storage
Store intact vials under refrigeration. Protect from light. Reconstituted vials are stable, protected from light, for 24 hours at room temperature and 1 week when refrigerated. Parenteral admixtures are stable, protected from light, for 24 hours at room temperature and 2 days under refrigeration. Short-term exposure (<24 hours) to light during I.V. infusion does not appreciably affect potency.
Reconstitution
Add 10 mL of SWFI (without a bacteriostatic agent) to each vial of amphotericin B. Further dilute with 250-500 mL D5W; final concentration should not exceed 0.1 mg/mL (peripheral infusion) or 0.25 mg/mL (central infusion).
Compatibility
Solution: Stable in D5W; incompatible with D5LR, D51/4NS, D51/2NS, D5NS, D5R, LR, R, NS.
Y-site administration: Compatible: Aldesleukin, amiodarone, tacrolimus, teniposide, thiotepa, zidovudine. Incompatible: Allopurinol, amifostine, Aminosyn® II, amsacrine, anidulafungin, aztreonam, bivalirudin, caspofungin, cefepime, dexmedetomidine, docetaxel, doxorubicin liposomal, enalaprilat, etoposide phosphate, fenoldopam, filgrastim, fludarabine, FreAmine® III, gemcitabine, granisetron, hetastarch in lactate electrolyte injection (Hextend®), linezolid, melphalan, meropenem, ondansetron, paclitaxel, pantoprazole, pemetrexed, piperacillin/tazobactam, propofol, tigecycline, vinorelbine. Variable (consult detailed reference): Cefpirome, cisatracurium, doripenem, fluconazole, foscarnet, magnesium sulfate, remifentanil, sargramostim.
Compatibility in syringe: Compatible: Heparin. Incompatible: Pantoprazole.
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).
Pharmacodynamics/Kinetics
Distribution: Minimal amounts enter the aqueous humor, bile, CSF (inflamed or noninflamed meninges), pericardial fluid, pleural fluid, and synovial fluid
Protein binding, plasma: 90%
Half-life elimination: Biphasic: Initial: 15-48 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
Dosage
Premedication: For patients who experience infusion-related immediate reactions, premedicate with the following drugs 30-60 minutes prior to drug administration: NSAID ± diphenhydramine or acetaminophen with diphenhydramine or hydrocortisone. If the patient experiences rigors during the infusion, meperidine may be administered.
Usual dosage ranges:
Infants and Children:
Test dose: I.V.: 0.1 mg/kg/dose to a maximum of 1 mg; infuse over 30-60 minutes. Many clinicians believe a test dose is unnecessary.
Maintenance dose: 0.25-1 mg/kg/day given once daily; infuse over 2-6 hours. Once therapy has been established, amphotericin B can be administered on an every-other-day basis at 1-1.5 mg/kg/dose; cumulative dose: 1.5-2 g over 6-10 weeks.
Duration of therapy: Varies with nature of infection, usual duration is 4-12 weeks or cumulative dose of 1-4 g
Adults:
Test dose: 1 mg infused over 20-30 minutes. Many clinicians believe a test dose is unnecessary.
Maintenance dose: Usual: 0.3-1.5 mg/kg/day; 1-1.5 mg/kg over 4-6 hours every other day may be given once therapy is established; aspergillosis, rhinocerebral mucormycosis, often require 1-1.5 mg/kg/day; do not exceed 1.5 mg/kg/day
Indication-specific dosing:
Infants and Children:
Aspergillosis (HIV-exposed/-positive): I.V.: 1-1.5 mg/kg/day once daily (CDC, 2009)
Candidiasis (HIV-exposed/-positive):
Invasive: I.V.: 0.5-1.5 mg/kg/day once daily (CDC, 2009)
Esophageal: I.V.: 0.3-0.5 mg/kg/day once daily (CDC, 2009)
Oropharyngeal, refractory: I.V.: 0.3-0.5 mg/kg/day (CDC, 2009)
Coccidioidomycosis (HIV-exposed/-positive): I.V.: 0.5-1 mg/kg/day (CDC, 2009)
Cryptococcus,
CNS disease (HIV-exposed/-positive): I.V.: 0.7-1 mg/kg/day plus flucytosine; Note: Minimum 2 week induction followed by consolidation and chronic suppressive therapy; may increase amphotericin dose to 1.5 mg/kg/day if flucytosine is not tolerated.
Cryptococcus,
disseminated (non-CNS disease) or severe pulmonary disease (HIV-exposed/-positive): I.V.: 0.7-1 mg/kg/day once daily with or without flucytosine
Histoplasma, CNS or severe disseminated: I.V.: 1 mg/kg/day once daily (CDC, 2009)
Adults:
Aspergillosis, disseminated: I.V.: 0.6-0.7 mg/kg/day for 3-6 months
Bone marrow transplantation (prophylaxis): I.V.: Low-dose amphotericin B 0.1-0.25 mg/kg/day has been administered after bone marrow transplantation to reduce the risk of invasive fungal disease.
Candidemia (neutropenic or non-neutropenic): I.V.: 0.5-1 mg/kg/day until 14 days after first negative blood culture and resolution of signs and symptoms (Pappas, 2009)
Candidiasis, chronic, disseminated: I.V.: 0.5-0.7 mg/kg/day for 3-6 months and resolution of radiologic lesions (Pappas, 2009)
Dematiaceous fungi: I.V.: 0.7 mg/kg/day in combination with an azole
Endocarditis: I.V.: 0.6-1 mg/kg/day (with or without flucytosine) for 6 weeks after valve replacement; Note: If isolates susceptible and/or clearance demonstrated, guidelines recommend step-down to fluconazole; also for long-term suppression therapy if valve replacement is not possible (Pappas, 2009)
Endophthalmitis, fungal:
Intravitreal (unlabeled use): 10 mcg in 0.1 mL (in conjunction with systemic therapy)
I.V.: 0.7-1 mg/kg/day (with or without flucytosine) for at least 4-6 weeks (Pappas, 2009)
Esophageal candidiasis: I.V.: 0.3-0.7 mg/kg/day for 14-21 days after clinical improvement (Pappas, 2009)
Histoplasmosis: Chronic, severe pulmonary or disseminated: I.V.: 0.5-1 mg/kg/day for 7 days, then 0.8 mg/kg every other day (or 3 times/week) until total dose of 10-15 mg/kg; may continue itraconazole as suppressive therapy (lifelong for immunocompromised patients)
Meningitis:
Candidal: I.V.: 0.7-1 mg/kg/day (with or without flucytosine) for at least 4 weeks; Note: Liposomal amphotericin favored by IDSA guidelines based on decreased risk of nephrotoxicity and potentially better CNS penetration (Pappas, 2009)
Cryptococcal or Coccidioides: I.T.: Initial: 0.01-0.05 mg as single daily dose; may increase daily in increments of 0.025-0.1 mg as tolerated (maximum: 1.5 mg/day; most patients will tolerate a maximum dose of ~0.5 mg/treatment). Once titration to a maximum tolerated dose is achieved, that dose is administered daily. Once CSF improvement noted, may decrease frequency on a weekly basis (eg, 5 times/week, then 3 times/week, then 2 times/week, then once weekly, then once every other week, then once every 2 weeks, etc) until administration occurs once every 6 weeks. Typically, concurrent oral azole therapy is maintained (Stevens, 2001). Note: IDSA notes that the use of I.T. amphotericin for cryptococcal meningitis is generally discouraged and rarely necessary (Perfect, 2010).
Histoplasma: I.V.: 0.5-1 mg/kg/day for 7 days, then 0.8 mg/kg every other day (or 3 times/week) for 3 months total duration; follow with fluconazole suppressive therapy for up to 12 months
Meningoencephalitis, cryptococcal (Perfect, 2010): I.V.:
HIV positive: Induction: 0.7-1 mg/kg/day (plus flucytosine 100 mg/kg/day) for 2 weeks, then change to oral fluconazole for at least 8 weeks; alternatively, amphotericin (0.7-1 mg/kg/day) may be continued uninterrupted for 4-6 weeks; maintenance: amphotericin 1 mg/kg/week for ≥1 year may be considered, but inferior to use of azoles
HIV negative: Induction: 0.7-1 mg/kg/day (plus flucytosine 100 mg/kg/day) for 2 weeks (low-risk patients), ≥4 weeks (non-low-risk, but without neurologic complication, immunosuppression, underlying disease, and negative CSF culture at 2 weeks), >6 weeks (neurologic complication or patients intolerant of flucytosine) Follow with azole consolidation/maintenance treatment.
Oropharyngeal candidiasis: I.V.: 0.3 mg/kg/day for 7-14 days (Pappas, 2009)
Osteoarticular candidiasis: I.V.: 0.5-1 mg/kg/day for several weeks, followed by fluconazole for 6-12 months (osteomyelitis) or 6 weeks (septic arthritis) (Pappas, 2009)
Penicillium marneffei:
I.V.: 0.6 mg/kg/day for 2 weeks
Pneumonia: Cryptococcal (mild-to-moderate): I.V.:
HIV positive: 0.5-1 mg/kg/day
HIV negative: 0.5-0.7 mg/kg/day (plus flucytosine) for 2 weeks
Sporotrichosis: Pulmonary, meningeal, osteoarticular, or disseminated: I.V.: Total dose of 1-2 g, then change to oral itraconazole or fluconazole for suppressive therapy
Urinary tract candidiasis (Pappas, 2009):
Fungus balls: I.V.: 0.5-0.7 mg/kg/day with or without flucytosine 25 mg/kg 4 times daily
Pyelonephritis: I.V.: 0.5-0.7 mg/kg/day with or without flucytosine 25 mg/kg 4 times daily for 2 weeks
Symptomatic cystitis: I.V.: 0.3-0.6 mg/kg/day for 1-7 days
Bladder irrigation: Irrigate with 50 mcg/mL solution instilled periodically or continuously for 5-10 days or until cultures are clear for fluconazole-resistant Candida
Dosing adjustment in renal impairment: 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; I.V. therapy may take several months
Renal replacement therapy: Poorly dialyzed; no supplemental dose or dosage adjustment necessary, including patients on intermittent hemodialysis or CRRT.
Peritoneal dialysis (PD): Administration in dialysate: 1-2 mg/L of peritoneal dialysis fluid either with or without low-dose I.V. amphotericin B (a total dose of 2-10 mg/kg given over 7-14 days). Precipitate may form in ionic dialysate solutions.
Administration: I.V.
May be infused over 4-6 hours. For a patient who experiences chills, fever, hypotension, nausea, or other nonanaphylactic infusion-related reactions, premedicate with the following drugs 30-60 minutes prior to drug administration: A nonsteroidal (eg, ibuprofen, choline magnesium trisalicylate) ± 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. Infusion of admixtures more concentrated than 0.25 mg/mL should be limited to patients absolutely requiring volume contraction.
Administration: I.V. Detail
Precipitate may form in ionic dialysate solutions.
pH: 5.7 (100 mg/L in D5W)
Monitoring Parameters
Renal function (monitor frequently during therapy), electrolytes (especially potassium and magnesium), liver function tests, temperature, PT/PTT, CBC; monitor input and output; monitor for signs of hypokalemia (muscle weakness, cramping, drowsiness, ECG changes, etc)
Reference Range
Therapeutic: 1-2 mcg/mL (SI: 1-2.2 micromole/L)
Test Interactions
Increased BUN (S), serum creatinine, alkaline phosphate, bilirubin; decreased magnesium, potassium (S)
Patient Education
I.V.: You will be monitored closely during and after infusion; report immediately any pain or swelling at infusion site, chills, nausea, chest pain, swelling of face or mouth, difficulty breathing, muscle cramping, acute anxiety, or other infusion reactions. May cause nausea, vomiting, anorexia, generalized muscle or joint pain, or hypotension. Report severe muscle cramping or weakness; chest pain or palpitations; CNS disturbances; skin rash; change in urinary patterns or difficulty voiding; unusual bruising or bleeding; or pain, redness, or swelling at infusion site.
Geriatric Considerations
The pharmacokinetics and dosing of amphotericin have not been studied in elderly. It appears that use is similar to young adults; caution should be exercised and renal function and desired effect monitored closely.
Additional Information
Premedication with diphenhydramine and acetaminophen may reduce the severity of acute infusion-related reactions. Meperidine reduces the duration of amphotericin B-induced rigors and chilling. Hydrocortisone may be used in patients with severe or refractory infusion-related reactions. 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. Infusion of admixtures more concentrated than 0.25 mg/mL should be limited to patients absolutely requiring volume restriction. Amphotericin B does not have a bacteriostatic constituent, subsequently admixture expiration is determined by sterility more than chemical stability.
Anesthesia and Critical Care Concerns/Other Considerations
Clinical Pearls/Comments:
Prevention of Infusion-Related Reactions: Patients may be premedicated with acetaminophen 650 mg and diphenhydramine 25-50 mg 30 minutes prior to infusion. Hydrocortisone (50-100 mg) can be used if patient has experienced rigors with amphotericin in the past. Meperidine can also be used for the treatment of rigors during the infusion.
Avoid rapid injection (usually 4- to 6-hour infusion required). Dosage adjustments are not necessary with renal impairment. If decreased renal function is due to amphotericin, the daily dose can be decreased by 50% or the dose can be given every other day.
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. Infusion of admixtures more concentrated than 0.25 mg/mL should be limited to patients absolutely requiring volume restriction. Amphotericin B does not have a bacteriostatic constituent, subsequently admixture expiration is determined by sterility more than chemical stability.
Dental Health: Effects on Dental Treatment
No significant effects or complications reported
Dental Health: Vasoconstrictor/Local Anesthetic Precautions
No information available to require special precautions
Mental Health: Effects on Mental Status
Sedation is common; may cause delirium
Mental Health: Effects on Psychiatric Treatment
May cause bone marrow suppression; use caution with clozapine and carbamazepine
Nursing: Physical Assessment/Monitoring
Assess culture and sensitivity report and patient's previous exposure to amphotericin B prior to starting therapy. Assess potential for interactions with other nephrotoxic drugs patient may be taking. Patient should be monitored closely for infusion-related reactions (eg, anaphylaxis, chills, fever, nausea, vomiting, rigors, hypotension, acute respiratory distress) and cardiopulmonary resuscitation should be available. If acute respiratory distress occurs, infusion should be stopped and prescriber notified.
Dosage Forms
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Injection, powder for reconstitution, as desoxycholate: 50 mg
References
Arsura EL, Ismail Y, Freedman S, et al, “Amphotericin B-Induced Dilated Cardiomyopathy,” Am J Med, 1994, 97(6):560-2.
Benson JM and Nahata MC, “Clinical Use of Systemic Antifungal Agents,” Clin Pharm, 1988, 7(6):424-38.
Benson JM and Nahata MC, “Pharmacokinetics of Amphotericin B in Children,” Antimicrob Agents Chemother, 1989, 33(11):1989-93.
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.
Centers for Disease Control and Prevention, “Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV-Exposed and HIV-Infected Children: Recommendations from CDC, the National Institutes of Health, the HIV Medicine Association of the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the American Academy of Pediatrics,” MMWR Recomm Rep, 2009, 58(RR-11):1-166. Available at http://aidsinfo.nih.gov/contentfiles/Pediatric_OI.pdf
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.
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.
Gales MA and Gales BJ, “Rapid Infusion of Amphotericin B in Dextrose,” Ann Pharmacother, 1995, 29(5):523-9.
Gallis HA, Drew RH, and Pickard WW, “Amphotericin B: 30 Years of Clinical Experience,” Rev Infect Dis, 1990, 12(2):308-29.
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.
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.
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.
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.
King CT, Rogers PD, Cleary JD, et al, "Antifungal Therapy During Pregnancy," Clin Infect Dis, 1998, 27(5):1151-60.
Kintzel PE and Smith GH, “Practical Guidelines for Preparing and Administering Amphotericin B,” Am J Hosp Pharm, 1992, 49(5):1156-64.
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.
Lyman CA and Walsh TJ, “Systemically Administered Antifungal Agents. A Review of Their Clinical Pharmacology and Therapeutic Applications,” Drugs, 1992, 44(1):9-35.
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.
Mohr J, Johnson M, Cooper T, et al, “Current Options in Antifungal Pharmacotherapy,” Pharmacotherapy, 2008, 28(5):614-45.
Pappas PG, Kauffman CA, Andes D, et al, “Clinical Practice Guidelines for the Management of Candidiasis: 2009 Update by the Infectious Diseases Society of America,” Clin Infect Dis, 2009, 48(5):503-35.
Patel R, “Antifungal Agents. Part I. Amphotericin B Preparations and Flucytosine,” Mayo Clin Proc, 1998, 73(12):1205-25.
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.
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.
Rex JH, Walsh TJ, Sobel JD, et al, “Practice Guidelines for the Treatment of Candidiasis. Infectious Diseases Society of America," Clin Infect Dis, 2000, 30(4):662-78.
Slain D, “Lipid-Based Amphotericin B for the Treatment of Fungal Infections,” Pharmacotherapy, 1999, 19(3):306-23.
Stevens DA and Shatsky SA, "Intrathecal Amphotericin in the Management of Coccidioidal Meningitis," Semin Respir Infect, 2001, 16(4):263-9.
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.
International Brand Names
Lexi-Comp.com
Last full review/revision January 2012
|
