A retrospective study was undertaken to assess the use of the antifung
al agent amphotericin B in a major acute care hospital. Data were revi
ewed from 82 patients who were prescribed amphotericin B at Vancouver
General Hospital between March 1 and September 1, 1990. Sixty-one perc
ent of the patients treated with amphotericin B were from the hematolo
gy service, 22% were from the intensive care unit (ICU) service, and t
he remainder were from other hospital services. Fever of unknown origi
n was the most common reason for amphotericin B use in the hematology
patients, while candidemia was most prevalent in the ICU patients. Ren
al dysfunction during treatment was common and related to the dose rec
eived. Test doses were used in the majority of courses, and premedicat
ions were also common. Cumulative doses administered were typically lo
wer than intended. Amphotericin B treatment was considered successful
in 46% of the cases reviewed. This review provides insight into how am
photericin B is used at one hospital and how this use may be improved.
Potential applications for fluconazole are also discussed.