This study is a draft guidance invivo study that does not mandate change in practice. There is a study that shows precipitation when Ambisome is combined with intralipid. There are no studies that show safety of Ambisome when infused as Y site therefore Ambisome is not recommended to be infused with PN/Lipid. Pharmacokinetic derangement is a possibility.
If Ambisome is indicated, it should not be infused as Y site with neither PN or Lipid. The calorie intake from Ambisome is not significant and we should not dig further towards its consideration.