What is the recommended dosage for Amphotericin B nebulization?

From the Guidelines

The recommended dosage for Amphotericin B nebulization is 12.5 mg on 2 consecutive days per week for prophylaxis, as stated in the guideline for diagnosis and management of invasive aspergillosis in neonates and children 1.

Key Points

• The dosage of 12.5 mg on 2 consecutive days per week is specified for aerosolized liposomal amphotericin B for prophylaxis in the guideline 1.
• Another study suggests that 25 mg of liposomal amphotericin B was effective in achieving protection of patients with lung transplants from infection by Aspergillus over a 15-day period, without any systemic absorption being detected and without any ill-effects on lung function 1.
• The administration of amphotericin B lipid complex in nebulized form, at a dose of 50 mg every 2 days for the first 3 weeks and once weekly thereafter, has also been shown to be effective in lung transplant patients 1.

Considerations

• The choice of dosage may depend on the specific patient population and the indication for prophylaxis or treatment.
• The guideline provides a specific dosage for aerosolized liposomal amphotericin B, while the other study suggests alternative dosages for liposomal amphotericin B and amphotericin B lipid complex.
• It is essential to consider the potential side effects and interactions of amphotericin B when selecting a dosage and administration route.

From the Research

Recommended Dosage for Amphotericin B Nebulization

The recommended dosage for Amphotericin B nebulization varies depending on the study and the specific formulation used. Here are some key points to consider:

• A study published in 2021 2 compared the safety and effectiveness of nebulized amphotericin B administered twice daily versus three times daily for the prevention of Aspergillus infection in lung transplant patients. However, it did not specify the exact dosage used.
• A 2007 study 3 used nebulized liposomal amphotericin B at a dosage of 20-15 mg twice daily in combination with intravenous liposomal amphotericin B and caspofungin for the treatment of severe pulmonary aspergillosis.
• A review of unlabeled uses of nebulized medications published in 2006 4 suggested a typical dosage of 25 mg every 24 hours for nebulized amphotericin B to prevent infections in immunocompromised patients.
• A 2017 case report 5 used nebulized liposomal amphotericin B in combination with intravenous liposomal amphotericin B for the treatment of pulmonary infection caused by Hormographiella aspergillata, but did not specify the exact dosage used.
• A comparative review of amphotericin B formulations published in 2013 6 discussed the recommended therapeutic dosages for different lipid-associated formulations, including amphotericin B lipid complex (5 mg/kg/day), liposomal amphotericin B (3-6 mg/kg/day), and amphotericin B colloidal dispersion (3-4 mg/kg/day). However, it did not provide specific guidance on nebulized dosages.

Key Considerations

Some key considerations when determining the dosage for Amphotericin B nebulization include:

• The specific formulation used (e.g. liposomal amphotericin B, amphotericin B lipid complex)
• The indication for use (e.g. prevention of Aspergillus infection, treatment of pulmonary aspergillosis)
• The patient population (e.g. lung transplant patients, immunocompromised patients)
• The potential for side effects and interactions with other medications.