AMPHOTERICIN-B USE IN A COMMUNITY-HOSPITAL, WITH SPECIAL EMPHASIS ON SIDE-EFFECTS

The purpose of this study was to analyze the usage of amphotericin B d esoxycholate in a small community hospital, with special emphasis on i ts side effects and need for premedication. We performed a retrospecti ve chart review for patients who received intravenous amphotericin B f rom January 1993 to May 1996. Temperature elevation, clinical symptoms during infusion, need for premedication, and fluctuations in serum po tassium and creatinine values were especially noted. Statistical analy sis showed that toxicity indicated by laboratory values (laboratory to xicity) increased with increasing amphotericin B dose, but clinical si de-effects decreased with advancing age. Clinical side effects were no t associated with total amphotericin B dosage; laboratory toxicity in our study was not more prevalent in elderly patients. The main finding of this study was that most patients tolerate amphotericin B well and only 23% of patients needed premedication. Our fungal cure rate was 8 3%. New, expensive preparations of amphotericin B should be reserved f or the small subset of patients who either are intolerant of amphoteri cin B desoxycholate or need high doses for systemic fungal infections.