Which parameter is essential to monitor in neonates receiving amphotericin B?

• A. Renal function
• B. ALT/AST
• C. Coagulation studies
• D. Serum lipids

Answer: (A)

Amphotericin B carries a high risk of nephrotoxicity, especially in neonates, so monitoring renal function is essential. The drug can cause direct tubular injury and reduced kidney perfusion, leading to a fall in glomerular filtration with rising serum creatinine and BUN and decreased urine output. It also causes electrolyte losses (notably potassium and magnesium), so tracking electrolytes alongside renal markers helps detect toxicity early and guides dose adjustments or consideration of less nephrotoxic formulations. Liver enzymes, coagulation studies, and lipid levels aren’t the primary concerns with amphotericin B toxicity, so they’re not the key parameters to monitor for this therapy.