Pharmacokinetics of amphotericin B lipid complex in critically ill patients on continuous veno-venous haemofiltration

Pharmacokinetics of amphotericin B lipid complex (ABLC) was determined in two critically ill patients requiring continuous veno-venous haemofiltration (CVVH) because of acute renal failure. ABLC was administered at a mean daily dose of 4.94 mg/kg for suspected invasive mycosis. Mean C(max) was 0.56 microg/ml, the mean AUC(0-24 h) was 7.46 mgh/l, V(ss) 9.13 l/kg, and t(1/2) was 13.21 h. The haemofilter clearance accounted about 20% of the total ABLC clearance. In one patient sampling was repeated after CVVH had been discontinued. The concentration-time profiles were very similar on and off haemofiltration. Data on our two patients suggest, that pharmacokinetics of ABLC is not significantly affected by CVVH and that ABLC can be administered at the standard doses during CVVH.