Efficacy and safety of amphotericin B lipid-based formulations-A systematic review and meta-analysis

Mycoses. 2017 Mar;60(3):146-154. doi: 10.1111/myc.12585. Epub 2016 Nov 22.


Invasive fungal infections, an important cause of mortality, are primarily treated using amphotericin B, which is available in different formulations, both conventional and lipid-based (liposomal, lipid complex, colloidal dispersion and Intralipid® infusion). The aim of our study was to determine the efficacy and safety of conventional amphotericin B vs its lipid-based formulations. A systematic review followed by pairwise meta-analysis was performed, including randomised controlled trials (RCTs) that evaluated the use of lipid-based amphotericin B in patients with any degree of immunosuppression and susceptibility to invasive fungal infection. An electronic search was conducted using PubMed, Scopus, Web of Science and Scielo databases. Extracted outcomes were related to efficacy (cure) and safety (incidence of adverse events). Results were evaluated and meta-analyses were performed. Twenty-three RCTs were identified (n=2677 participants) for meta-analysis. No significant differences between conventional amphotericin B and any of the five formulations evaluated were observed, with regard to the efficacy analysis. With respect to the adverse events of nephrotoxicity, fever, chills and vomiting, all lipid formulations presented better profiles than the conventional formulation. The present systematic review and meta-analysis showed that conventional amphotericin B presents the same efficacy profile as lipid-based formulations, although the latter were associated with a safer profile.

Keywords: amphotericin B; immunosuppression; lipid-based amphotericin B; meta-analysis; systematic review.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Amphotericin B / administration & dosage*
  • Amphotericin B / adverse effects
  • Amphotericin B / therapeutic use
  • Antifungal Agents / administration & dosage*
  • Antifungal Agents / adverse effects
  • Antifungal Agents / therapeutic use
  • Clinical Trials as Topic
  • Colloids
  • Drug Compounding
  • Emulsions
  • Fever
  • Humans
  • Invasive Fungal Infections / drug therapy*
  • Invasive Fungal Infections / microbiology
  • Invasive Fungal Infections / mortality
  • Lipids
  • Phospholipids
  • Soybean Oil


  • Antifungal Agents
  • Colloids
  • Emulsions
  • Lipids
  • Phospholipids
  • liposomal amphotericin B
  • soybean oil, phospholipid emulsion
  • Amphotericin B
  • Soybean Oil