Amphotericin B phospholipid complex: new to dm+d
The NHS Business Services Authority has added Amphotericin B phospholipid complex to the dm+d dictionary (version 5.0.0). This is a polyene antifungal used to treat serious systemic fungal infections in hospital and specialist care settings.
What is it used for?
Amphotericin B phospholipid complex is indicated for:
- Invasive aspergillosis
- Systemic candidiasis
- Cryptococcosis
- Other serious systemic fungal infections in immunocompromised patients
It is administered intravenously, typically at 3–4 mg/kg once daily, with dosing adjusted according to infection severity and renal function.
Event medicine relevance
Amphotericin B phospholipid complex is not suitable for field administration at events. It requires IV infusion over 30–60 minutes in a controlled hospital setting with full clinical monitoring. If an event attendee requires this medication, they should be conveyed urgently to hospital. Responders may encounter patients already receiving this drug who develop infusion reactions (fever, rigors, hypotension) or complications; recognition and safe transfer remain key.
Key cautions and interactions
Baseline and twice-weekly monitoring of serum creatinine, urea, potassium, and magnesium is essential. Nephrotoxicity is the primary concern. Avoid concurrent use with NSAIDs, aminoglycosides, and ciclosporin, all of which increase renal impairment risk. Corticosteroids and diuretics increase electrolyte depletion. Hepatic impairment, cardiac disease, and pregnancy require careful risk–benefit assessment.
Common side effects include fever, chills, nausea, and electrolyte disturbances. Serious adverse effects include acute kidney injury, anaphylaxis, cardiac arrhythmias, and thrombophlebitis at the infusion site.