Fatal overdose of amphotericin B in two preterm infants

Two premature infants exhibited an acute cardiorespiratory collapse shortly after receiving a 50-fold overdose of amphotericin B (AmB). Despite aggressive intervention both infants died. Serum AmB levels were double the normal therapeutic range. We speculate that two less well-recognized toxic complications of AmB involving the cardiac and respiratory systems may have contributed to the fatal outcome.