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Amphotericin B

Grade

Sensitive Infections

We offer no GRADED recommendations regarding patient suitability, indication suitability or the suitability, safety or efficacy of any dosing protocol.


  • Experimental use is reported in journal papers, and the current mainstream veterinary textbooks cited offer anecdotal dosing suggestions.


Experimental Protocols

  • Systemic Fungal Infections/Experimental Candidiasis: Combination therapy (Img/kg, q24h, IV with Fluconazole (100 mg/kg, q24h, IP). (Sanati et al., 1997).

Anecdotal Protocols

  • Systemic Fungal Infections: 1 mg/kg IV, q24h (Desoxycholate) or 5 mg/kg IV, q24h (Liposomal) (Hedley and BSAVA, 2023)

  • Systemic Fungal Infections:  Use proposed but no dose specified (Carpenter and Harms, 2023; Smith, 2022)

Therapeutics

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Formulation Information

Desoxycholate vs Liposomal Preparations

Available formulations differ in the following properties

  • Dosing:

  • Toxicity:

  • Activity:

Adverse Effects Profile

  • Rabbit: Proposed nephrotoxicity and hepatotoxicity (Sanati et al., 1997)

Evidence

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1 Species-Specific Evidence Review

  1. Al-Nakeeb, Z., Petraitis, V., Goodwin, J., Petraitiene, R., Walsh, T.J., Hope, W.W., 2015. Pharmacodynamics of Amphotericin B Deoxycholate, Amphotericin B Lipid Complex, and Liposomal Amphotericin B against Aspergillus fumigatus. Antimicrob Agents Chemother 59, 2735–2745. https://doi.org/10.1128/AAC.04723-14

  2. Petraitis, V., Petraitiene, R., Groll, A.H., Roussillon, K., Hemmings, M., Lyman, C.A., Sein, T., Bacher, J., Bekersky, I., Walsh, T.J., 2002. Comparative Antifungal Activities and Plasma Pharmacokinetics of Micafungin (FK463) against Disseminated Candidiasis and Invasive Pulmonary Aspergillosis in Persistently Neutropenic Rabbits. Antimicrob Agents Chemother 46, 1857–1869. https://doi.org/10.1128/AAC.46.6.1857-1869.2002

  3. Sanati, H., Ramos, C.F., Bayer, A.S., Ghannoum, M.A., 1997. Combination therapy with amphotericin B and fluconazole against invasive candidiasis in neutropenic-mouse and infective-endocarditis rabbit models. Antimicrob Agents Chemother 41, 1345–1348.

5 Supplementary Information 

5.2 Additional Material Consulted

  1. Carpenter, J.W., Harms, C.A. (Eds.), 2023. Carpenter’s Exotic Animal Formulary, Sixth edition. ed. Elsevier, St. Louis, Missouri.

  2. Hedley, J., BSAVA (Eds.), 2023. Small Animal Formulary: Part B: Exotic Pets, 11th edition,. ed. BSAVA, British Small Animal Veterinary Association, Quedgeley, Gloucester.

  3. Smith, M., 2022. Textbook of Rabbit Medicine,  3rd Edition, Elsevier Limited.  Available from: vbk://9780702084041.

Monograph Details

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