AMPHOTERICIN-B USE IN A MAJOR ACUTE-CARE HOSPITAL

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.