Amphotericin B

Abstract

In spite of serious toxicities, amphotericin B remains the most important antifungal agent and the one against which new agents are compared. The antifungal spectrum of amphotericin B is quite broad; few organisms are innately resistant or acquire resistance during treatment. The drug has poor pharmacologic attributes: intravenous administration is required, protein binding is high, and penetration into body fluids is low. Infusion-related reactions (fever, chills, nausea, myalgias) are the most common side effects, and nephrotoxicity is the major dose-limiting toxicity. Infusion-related reactions can usually be diminished by pretreatment medications. In many patients, nephrotoxicity can be decreased by the administration of saline prior to each infusion. Potassium and magnesium losses through the distal tubules may be high and almost always require aggressive replacement. With careful attention to detail, amphotericin B can be safely used and is often the most appropriate antifungal agent for patients with life-threatening fungal infections.

Key Words:

amphotericin B - antifungal therapy