Dosing Implications for Liposomal Amphotericin B in Pregnancy

We describe the use of LAmB for a pregnant patient with mucocutaneous leishmaniasis (MCL) using a dosing strategy of 5 mg/kg/day for days 1-7 using ideal body weight followed by 4 mg/kg weekly using adjusted body weight. We reviewed the literature for LAmB dosing strategies, particularly dosing weight, in pregnancy.ResultsOf the 143 cases identified in 17 studies only one reported a dosing weight, in which ideal body weight was used. Five Infectious Diseases Society of America (IDSA) guidelines in total discussed the use of amphotericin B in pregnancy but no guidelines included recommendations for dosing weight.DiscussionThis review describes our experience in using ideal body weight for dosing LAmB in pregnancy for the treatment of MCL. Use of ideal body weight may minimize risk of adverse effects to the fetus compared to the use of total body weight while maintaining efficacy for treatment of MCL in pregnancy.
Source: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy - Category: Drugs & Pharmacology Authors: Tags: REVIEW Source Type: research