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• Amphotericin B in a liposomal formulation
• Higher doses (compared with conventional amphotericin B) are required for equivalent effect
• Usual Adult dose:1-3mg/kg OD or occasionally higher
• Very expensive - Consideration should be made for rounding the dose to the nearest 50mg to allow whole vials to be used.
• No dose adjustment necessary for renal impairment.
• Given by IV infusion after a test dose
• Less nephrotoxicity and acute side-effects compared to conventional IV amphotericin B

• Give an initial test dose of 1mg (from the first few mls of first dose) over 10 min and observe patient for 30 min before giving rest of infusion over 30-60 mins.

 Main indications

• Restricted to haematology and paediatric oncology
• Invasive fungal infections on microbiology advice, where other treatments have failed or significantly impaired renal function

Active against most strains of:

• Aspergillus sp. (not terreus)
• Yeasts e.g. Candida sp. and Cryptococcus neoformans
• Most moulds which cause mucormycosis e.g. Mucor sp.
• Dimorphic fungi e.g. Histoplasma capsulatum
• Some protozoa e.g. Acanthamoebae, Leishmania sp. and Naegaleria sp.

Not active against most strains of:

• Fusarium sp.
• Scedosporium sp.
• Trichosporon sp.
• Aspergillus terreus
• Malassezia furfur
• Dermatophytes e.g. Trichophyton sp.

Caution; the antibiotic doses recommended on this website are intended for adult patients with normal renal and liver function unless otherwise stated. Dosing advice for patients with renal impairment is available here.

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