Amphotericin B colloidal dispersion: an improved antifungal therapy

Area of Science:

• Mycology
• Pharmacology
• Infectious Diseases

Background:

• Systemic fungal infections pose a significant threat, particularly in immunocompromised patients.
• Conventional amphotericin B (AMB) is effective but associated with substantial toxicity, especially nephrotoxicity.
• Novel drug delivery systems are needed to improve AMB's safety profile.

Purpose of the Study:

• To evaluate the efficacy and safety of Amphotericin B colloidal dispersion (ABCD) compared to conventional amphotericin B (CAB).
• To assess the pharmacokinetic profile and tissue distribution of ABCD.
• To determine the tolerability and clinical outcomes of ABCD in patients with systemic fungal infections.

Main Methods:

• ABCD is a discoidal complex of AMB and sodium cholesteryl sulfate (SCS).
• In vitro and in vivo studies were conducted to assess efficacy and safety.
• A clinical trial involving 572 patients with systemic fungal infections was performed.

Main Results:

• ABCD demonstrated comparable efficacy to CAB with significantly reduced toxicity.
• ABCD exhibited lower peak plasma levels, prolonged residence time, and decreased AMB levels in key tissues like the kidney.
• In patients, ABCD was well-tolerated, with 57.3% achieving complete or partial recovery, even in those intolerant to CAB.

Conclusions:

• Amphotericin B colloidal dispersion (ABCD) represents a safer and effective alternative for treating systemic fungal infections.
• ABCD's improved safety profile, particularly reduced renal toxicity, makes it a valuable option.
• Consideration of ABCD as a primary treatment for systemic fungal infections is warranted.