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The antifungal agent amphotericin B is reputedly one of the most toxic medications in use today, and several less toxic (but more expensive) alternatives are now available. Does amphotericin still have a role in practice? This retrospective review examined the frequency of amphotericin toxicity in a small community hospital.
Between 1993 and 1996, 102 patients received 111 short courses of amphotericin for indications including fungemia (20 percent), funguria (18 percent), respiratory infections (15 percent), and empiric treatment (20 percent). Length of treatment averaged 8.3 days, and total dose ranged from 10 to 840 mg (mean, 162.5 mg). Pathogens isolated were primarily Candida species (89.7 percent). Treatment was successful in 83 percen…