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Hey #IDTwitter… what are your thoughts on intermittent (e.g. TIW frequency) liposomal amphotericin B (L-AmB) dosing for OPAT?

@MayoPharmRes @MsSmallsO @johnsontannerm @Stevens_AK @SIDPharm #opat #TwitteRx
Let’s look at the evidence… For starters, amphotericin B (AmB) = broad spectrum anti-fungal that binds to ergosterol

1st-line for serious ocular candida, CNS cryptococcus, severe histo/blasto, and mucor

2nd-line for cocci & aspergillosis

pubmed.ncbi.nlm.nih.gov/11801575/ Image
There are 4 formulations of AmB, but the liposomal form (L-AmB) is typically dosed at 3-5 mg/kg/day = ⬇️ nephrotoxicity (vs. deoxycholate) and ⬇️ infusion reactions (vs. ABLC) + liposome allows for ⬆️ tissue conc and a prolonged t1/2.

pubmed.ncbi.nlm.nih.gov/11722981/ Image
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