Case Report

Amphotericin B Pharmacokinetics During Extracorporea/Membrane Oxygenation: A Case Report

Departments of Pediatrics and Medicine, Divisions of Pediatric Critical Care Medicine and Clinical Pharmacology, Georgetown University Medical Center, Washington, D.C.

^* Address correspondence to: James H. Hertzog, MD Division of Pediatric Critical Care Medicine Room C5414 Georgetown University Hospital 3800 Reservoir Road NW Washington, D.C. 20007-2197

Abstract

Amphotericin B treatment during extracorporeal membrane oxygenation is at times necessary for the treatment of secondary fungemia or, less commonly, to treat a primary fungal infection. The impact of the extracorporeal circuit on the pharmacokinetics of amphotericin B have not been described in vivo. This case report describes the pharmacokinetics of amphotericin B in a patient receiving extracorporeal membrane oxygenation support for respiratory failure secondary to Blastomyces dermatitidis pneumonia. Amphotericin B concentrations were established and maintained at therapeutic levels with standard dosing despite the presence of a membrane oxygenator and intermittent replacement of extracorporeal circuit components. This suggests that no adjustments in the dosing of amphotericin B are necessary during extracorporeal membrane oxygenation.