Clinical Medicine Reviews in Therapeutics

Amphotericin B has been the mainstay of antifungal therapy for more than 50 years, but its associated toxicity often delayed or limited its use. In general, formulating this drug with phospholipids has greatly improved its safety and maintained its efficacy. In particular incorporating amphotericin B into a liposome produced a unique pharmacokinetic profile that altered its distribution, enhanced its safety and maintained its overall effectiveness in the treatment of infections due to pathogenic yeasts and invasive molds. Clinical trial experience and expert opinion suggest there are likely few differences between the lipid amphotericin B formulations. Although the composition of liposomal amphotericin B could improve the ability of amphotericin B to treat CNS fungal infections, to date human data do not completely corroborate findings in animals. This report summarizes the pharmacology, pharmacokinetics, clinical trial data and the Infectious Disease Society of America (IDSA) guidelines regarding the use of liposomal amphotericin B to treat systemic and invasive fungal infections.