Liposomal Amphotericin B formulation and its pharmakokinetics in the treatment of fungal infections

Abstract

Amphotericin B (AmB) continues to maintain an important role in the treatment of invasive fungal infections. The substance is almost insoluble in water. Therefore special pharmacological solutions are required to dissolve Am B – usually prepared with bile acid (Deoxycholat ((AmB/Doc)). The association of the lipophil substance with lipids leads to a clear increase in the patient's tolerance of the compound and makes possible the use of much higher doses. The liposomal formulation can however, at the same time change the typical distribution of AmB in the body. At the present time ambisone is the only liposomal AmB-formulation. AmB is also often administered in combination with Intralipid. AmB-Lipid complex (ABLC) and AmB-Colloidal (ABCD) are the other pharmaceutical preparations which could become available in the future. The importance of immune competence and of prophylactic measures to prevent invasive fungal infection are stressed.