Correction of serum electrolyte imbalance prevents cardiac arrhythmia during amphotericin B administration.

Arrhythmias and cardiac arrest have been reported during amphotericin B administration but no effective technique has been described to prevent them. I saw two patients with kala-azar resistant to sodium stibogluconate who developed cardiac arrest after amphotericin infusion (in spite of tolerating a test dose). Both had low levels of serum sodium, potassium and calcium. After these were corrected the amphotericin B was restarted and the course of treatment completed successfully. I suggest that prior to giving amphotericin B to patients with resistant kala-azar their electrolyte imbalance should be corrected.