Neonatal Intensive Care Drug Manual

Amphotericin B, in both its conventional and lipid formulation, has similar pharmacokinetics in neonates and children as in adults.⁶ Wurthwein et al⁸ conducted a pharmacokinetic study of amphotericin B lipid complex (ABLC) in 28 neonates (24–41 weeks gestation) with analysis of the drug concentration in blood, urine and CSF. The disposition of ABLC was similar to that observed in other age groups and weight was the only factor influencing clearance. No similar study on liposomal amphotericin B in the neonatal age group is available. Although amphotericin B formulations are known to cause nephrotoxicity and may cause hepatotoxicity, reducing the dose in these disease states is not currently recommended.¹⁹ If nephrotoxicity or hepatotoxicity is a significant concern, consider other antifungals.