AmBisome (liposomal amphotericin B)

Dosing: Adult Antimicrobial Dosing, Non-dialysis

Indication

Dose

Notes

Invasive fungal infections 5 mg/kg IV q24h

No adjustment for renal dysfunction; monitor serum creatinine and electrolytes

Mold prophylaxis (Heme/BMT) 3 mg/kg IV q24h

Dosing: Antimicrobial Dosing in Intermittent & Continuous Hemodialysis

Indication

Intermittent Hemodialysis

Continuous Hemodialysis
Invasive fungal infections 5 mg/kg IV q24h 5 mg/kg IV q24h
Prophylaxis (heme/BMT) 3 mg/kg IV q24h 3 mg/kg IV q24h

Dialysis Notes

Intermittent HD assumes high-flux hemodialysis. CRRT assumes CVVHD with ultrafiltration rate 2L/h and residual native GFR < 10 mL/min.  For detailed view of dialysis dosing and evidence, see Dosing in Hemodialysis document.

*Use Total Body Weight if Total Body Weight < Ideal Body Weight.  If Total Body Weight >1.2 times Ideal Body Weight, use Adjusted Body Weight

IV Fluids: Give 500mL Normal Saline before and after AmBisome administration if able to tolerate

Unrestricted Indications 1) Documented or suspected fungal pneumonia in a patient intolerant of or with contraindications to azoles 2) Prophylaxis against fungal infections in patients on the hematology/BMT service or lung transplant service 3) Empiric therapy for prolonged febrile neutropenia in hematology/oncology/BMT patient All other indications require approval from the Antimicrobial Stewardship Program or consulting ID fellow

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Dosing: Adult Antimicrobial Dosing, Non-dialysis

Indication

Dose

Notes

Invasive fungal infections 5 mg/kg IV q24h

No adjustment for renal dysfunction; monitor serum creatinine and electrolytes

Mold prophylaxis (Heme/BMT) 3 mg/kg IV q24h

Dosing: Antimicrobial Dosing in Intermittent & Continuous Hemodialysis

Indication

Intermittent Hemodialysis

Continuous Hemodialysis
Invasive fungal infections 5 mg/kg IV q24h 5 mg/kg IV q24h
Prophylaxis (heme/BMT) 3 mg/kg IV q24h 3 mg/kg IV q24h

Dialysis Notes

Intermittent HD assumes high-flux hemodialysis. CRRT assumes CVVHD with ultrafiltration rate 2L/h and residual native GFR < 10 mL/min.  For detailed view of dialysis dosing and evidence, see Dosing in Hemodialysis document.

*Use Total Body Weight if Total Body Weight < Ideal Body Weight.  If Total Body Weight >1.2 times Ideal Body Weight, use Adjusted Body Weight

IV Fluids: Give 500mL Normal Saline before and after AmBisome administration if able to tolerate

Unrestricted Indications 1) Documented or suspected fungal pneumonia in a patient intolerant of or with contraindications to azoles 2) Prophylaxis against fungal infections in patients on the hematology/BMT service or lung transplant service 3) Empiric therapy for prolonged febrile neutropenia in hematology/oncology/BMT patient All other indications require approval from the Antimicrobial Stewardship Program or consulting ID fellow

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