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Adverse effect profile of amphotericin B deoxycholate administered with a standardized infusion protocol in

Sreeraj Vasudevan1, Govind R Patel1, Pravas Mishra1

  • 1Department of Hematology, All India Institute of Medical Sciences, New Delhi, India.

Current Medical Research and Opinion
|May 5, 2026
PubMed
Abstract

Insights

Amphotericin B deoxycholate (AmBD) can be safely administered to hematologic patients using a standardized infusion protocol. This approach minimizes adverse events and electrolyte imbalances, making AmBD a viable antifungal option in resource-limited settings.

Area of Science:

  • Hematology
  • Infectious Diseases
  • Pharmacology

Background:

  • Amphotericin B deoxycholate (AmBD) is an effective, inexpensive antifungal but causes significant adverse effects.
  • Limited studies exist on mitigating AmBD's adverse effects in hematologic patients.
  • Hematologic disorders increase susceptibility to invasive fungal infections (IFIs).

Purpose of the Study:

  • To evaluate the adverse effect profile of AmBD administered with a standardized infusion protocol in hematologic patients.
  • To assess the incidence and reversibility of AmBD-associated adverse events.
  • To identify risk factors for AmBD-induced nephrotoxicity.

Main Methods:

  • Prospective observational study of 150 hospitalized hematologic patients receiving AmBD.
  • Standardized infusion protocol included premedication, IV hydration, salt loading, and electrolyte supplementation.
  • Monitoring of renal function, electrolytes, and AmBD-associated infusion-related adverse events (IRAEs).

Main Results:

  • AmBD-associated IRAEs, hypokalemia, hypomagnesemia, and nephrotoxicity occurred in 32%, 60%, 82%, and 28% of patients, respectively.
  • Most adverse effects were reversible, with low rates of treatment discontinuation.
  • Baseline IFI and AmBD dose >1 mg/kg were risk factors for nephrotoxicity.

Conclusions:

  • A standardized infusion protocol significantly reduces AmBD-related IRAEs and nephrotoxicity in hematologic patients.
  • Electrolyte imbalances are manageable with this protocol.
  • AmBD is a cost-effective antifungal for IFIs in hematologic patients, especially in resource-constrained settings.
Keywords:
Amphotericin B deoxycholate (AmBD)adverse effectshematological disordersinvasive fungal infections (IFIs)standardized infusion protocol

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