Liposomal amphotericin B for the treatment of severe fungal infection.
Amphotericin B is commonly used in the intensive care unit to treat invasive fungal infection. This medication is associated with a number of adverse events during infusion, such as fever, rigors, chills, electrolyte disorders and renal insufficiency. Liposomal amphotericin B can be used as an alternative to conventional amphotericin B to treat fungal infection. Patients receiving liposomal amphotericin B experience fewer adverse events than recipients of the conventional formulation; moreover, the liposomal formulation has been found to be as effective as the conventional amphotericin B to treat specific fungal infections. Unfortunately, the pharmacoeconomics of the liposomal formulation has limited the use of this medication. The purpose of this article is to present a brief summary of conventional amphotericin B with an emphasis on the narrow therapeutic index of this antibiotic. The liposomal amphotericin B solution is compared to conventional amphotericin B regarding the pharmacokinetics and pharmacodynamics. Therapeutic use, tolerability, and pharmacoeconomic implications of liposomal amphotericin B are discussed.
Michaud
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Royal Alexandra Hospital, Edmonton, Alberta.
D000666:Amphotericin B / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008081:Liposomes; D009181:Mycoses / Q000188:drug therapy*
D000935:Antifungal Agents; D008081:Liposomes; D000666:Amphotericin B