Lipid-based amphotericin B for the treatment of fungal infections

Pharmacotherapy. 1999 Mar;19(3):306-23. doi: 10.1592/phco.19.4.306.30934.

Abstract

The frequency of life-threatening fungal infections has increased dramatically over the past few decades. For more than 30 years amphotericin B has been the standard treatment for systemic and deep-seated fungal infections, primarily because of its broad spectrum of activity. Its usefulness is limited by a relatively high frequency of significant adverse events including infusion-related reactions and nephrotoxicity. In an effort to overcome these side effects, a number of lipid-based formulations were developed, each with its own composition and pharmacokinetic behavior. The clinical significance of these differences is unknown. Available clinical data suggest the formulations have a reduced propensity for causing nephrotoxicity. However, considering limited efficacy data, they should be reserved as second-line therapy for patients who cannot tolerate or fail an adequate trial of conventional amphotericin B or cannot benefit from other antifungal agents.

Publication types

  • Review

MeSH terms

  • Amphotericin B / administration & dosage*
  • Amphotericin B / pharmacokinetics
  • Amphotericin B / pharmacology
  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / pharmacokinetics
  • Anti-Bacterial Agents / pharmacology
  • Antifungal Agents / administration & dosage*
  • Antifungal Agents / pharmacokinetics
  • Antifungal Agents / pharmacology
  • Clinical Trials as Topic
  • Drug Carriers
  • Humans
  • Liposomes
  • Mycoses / drug therapy*

Substances

  • Anti-Bacterial Agents
  • Antifungal Agents
  • Drug Carriers
  • Liposomes
  • Amphotericin B