Pharmacology, toxicity, and therapeutic usefulness of amphotericin B

Abstract

Since introduction 10 years ago, amphotericin B has been used successfully in the treatment of local and systemic fungal infections, including histoplasmosis, coccidioidomycosis, cryptococcosis, South American and North American blastomycosis, sporotrichosis and candidiasis. Amphotericin B is available in 2 forms; the first, or microcrystalline form, is used topically and orally, and the second, or colloidal form, is used intravenously. The colloidal form also may be given by any of several additional routes, including intra-thecally. Administration of drug intravenously is accompanied by numerous immediate side effects as well as by anemia, electrolyte abnormalities, and renal impairment. Amphotericin B causes increased permeability of cellular membranes of both yeast and human cells, with subsequent leakage of essential intracellular constituents. It is probable that the chemotherapeutic and toxic properties of the drug are manifestations of a common mechanism of action.