Amphotericin B colloidal dispersion. Pre-clinical review

Amphotericin B Colloidal Dispersion (ABCD, AmphocilTM), a noncovalent complex of amphotericin B and cholesteryl sulfate, is active in vitro and in vivo against a wide variety of fungal species; its activity is broadly comparable to the range of activity of conventionally formulated amphotericin B (CAB). The pharmacokinetics of ABCD and CAB differ. ABCD is more rapidly removed from circulation than CAB, with more than 99% clearance one hour after administration, but has a much more prolonged terminal elimination phase. Preclinical safety studies have shown that ABCD is significantly better tolerated and less nephrotoxic than CAB. ABCD does cause renal tubular damage after high doses, but only at doses five- to eight-fold higher than those of CAB. Preclinical studies suggest that the efficacy, but not the toxicity of ABCD and CAB will be identical. ABCD may thus provide a safer therapeutic alternative to CAB.