| Summary: | Background: We aimed to establish the prevalence of adverse reactions associated with the use of deoxycholate and/or liposomal amphotericin B and to determine adherence to World Health Organization (WHO) recommendations to minimize the risk of toxicity. Methods: Clinical data were collected from records of 143 patients over 18 years of age who were under treatment with amphotericin B (deoxycholate and/or liposomal) for at least 5 days from January 2016 to March 2019 at National Institute of Respiratory Diseases "Ismael Cosío Villegas" in Mexico City. We used MeSH terms to name each formulation of amphotericin B, adverse reactions, and diagnoses. Definitions and classification of the adverse reactions were made in accordance with the Common Terminology Criteria for Adverse Events Version 5.0 and other bibliographic references. Preventability assessment was evaluated using the Schumock and Thornton scale. To determine adherence to WHO recommendations, we evaluated intravenous preemptive hydration, electrolyte supplementation, and laboratory test monitoring. Results: 105 patients (73.4%) were exposed to deoxycholate amphotericin B, 25 patients (17.5%) to liposomal amphotericin B, and 13 patients (9.1%) to both amphotericin B types. Hypokalemia was the most common adverse reaction (76.2%), followed by hypomagnesemia (47.6%), acute kidney injury (40.6%), infusion reactions (33.6%), anemia (20.3%), thrombocytopenia (7%), and neutropenia (4.9%). Electrolyte supplementation was the WHO recommendation that was less performed (28%), while preemptive hydration and laboratory test monitoring were well applied (82.5% and 84.6%). Conclusion: This study highlights the need to adhere to amphotericin B toxicity prevention recommendations as some of the most common adverse reactions are mostly preventable.
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