Related Experiment Video
Updated: Aug 17, 2026
Formulation and Characterization of Bioactive Agent Containing Nanodisks
Published on: March 17, 2023
Liposomal amphotericin B: clinical experience and perspectives
Winter J Gibbs1, Richard H Drew, John R Perfect
1Department of Pharmacy practice, Campbell University School of Pharmacy, Buies Creek. winter.gibbs@duke.edu
Abstract:
While amphotericin B deoxycholate (Fungizone, Apothecon Pharmaceuticals) has been considered by many to be the gold standard for the treatment for numerous invasive fungal infections for over 45 years, toxicities associated with its use often necessitate treatment modification or discontinuation. Lipid-based formulations, including liposomal amphotericin B (AmBisome, Fujisawa Healthcare, Inc.), were developed to decrease many of these toxicities while retaining broad antifungal spectrum and potency of amphotericin B. In clinical trials, liposomal amphotericin B has demonstrated efficacy comparable to that of amphotericin B deoxycholate while reducing the incidence of treatment-related nephrotoxicity, electrolyte-wasting, and infusion-related reactions. In addition, recent clinical trials have also compared liposomal amphotericin B with other antifungal classes. Acquisition costs of liposomal amphotericin B are substantially higher than those of amphotericin B deoxycholate and other antifungals. While pharmacoeconomic analyses consider outcomes and other treatment-related costs, they have yet to clearly demonstrate the cost-effectiveness of liposomal amphotericin B when compared with amphotericin B deoxycholate or other antifungal agents. This review will focus primarily on recent liposomal amphotericin B experience and attempt to put its use into perspective considering other available antifungal agents.
Insights
Liposomal amphotericin B offers comparable efficacy to amphotericin B deoxycholate for invasive fungal infections but with reduced toxicity. However, its higher acquisition cost requires further pharmacoeconomic evaluation for cost-effectiveness.
Area of Science:
- Mycology
- Infectious Diseases
- Pharmacology
Background:
- Amphotericin B deoxycholate has been a long-standing treatment for invasive fungal infections.
- Significant toxicities limit amphotericin B deoxycholate use, prompting development of safer alternatives.
- Lipid-based formulations, such as liposomal amphotericin B, aim to mitigate these toxicities.
Purpose of the Study:
- To review recent clinical experience with liposomal amphotericin B.
- To compare liposomal amphotericin B efficacy and safety against amphotericin B deoxycholate and other antifungals.
- To assess the pharmacoeconomic implications of liposomal amphotericin B use.
Main Methods:
- Review of clinical trials and pharmacoeconomic analyses.
- Comparison of efficacy, toxicity profiles, and acquisition costs.
- Evaluation of treatment-related outcomes and costs.
Main Results:
- Liposomal amphotericin B demonstrates comparable efficacy to amphotericin B deoxycholate.
- Liposomal amphotericin B shows a reduced incidence of nephrotoxicity, electrolyte wasting, and infusion reactions.
- Acquisition costs for liposomal amphotericin B are significantly higher; cost-effectiveness remains unclear.
Conclusions:
- Liposomal amphotericin B provides a safer alternative to amphotericin B deoxycholate for invasive fungal infections.
- Further pharmacoeconomic studies are needed to establish the overall cost-effectiveness of liposomal amphotericin B.
- Liposomal amphotericin B represents an important option in managing invasive fungal infections, balancing efficacy and safety.
Related Concept Videos
01:15Antifungal Agents
01:21Antiprotozoal Agents