Amphotericin B is an oral or injectable drug derived from Streptomyces nodosum bacteria. The drug settles in the plasma membrane of fungi and ensures a complete death of all fungi in all phases of their growth in the short and long term.

It was the most effective antifungal for many decades because very few types of fungi are resistant to treatment with amphotericin B.

Pharmacological action

Provided no side effects occur, amphotericin B should only act on fungal infections that are either in the mouth or in the digestive tract . However , local fungal infections on the skin can also be treated.Theoretically, amphotericin B can also fight infections in the respiratory tract or internal organs and the urinary tract , but due to the large number of side effects, most doctors use other preparations if this is possible. Amphotericin B either gets locally directly to the infected site (which is the case, for example, on the skin or in the mouth and intestines ) or in the form of an injection via the bloodstream to the target site.

The frequent side effects mentioned result, among other things, from the fact that amphotericin B sometimes not only attacks the fungi, but also cell membranes, which belong to healthy cells in the organism. Due to its proven effect, amphotericin B is rarely dispensed with in severe cases. Typically, amphotericin B is used until the fungal infection has been shown to be gone. This can be the case after just a few days, but the treatment can also extend over six to eight weeks.

Medical Application & Use

Amphotericin B is used as an antifungal to combat malignant fungal infections. It is used to eliminate yeast infections that have accumulated mainly in the oral cavity and gastrointestinal tract .

Treatment can be difficult for the patient, who usually needs to administer the doctor-selected dose four times a day. Amphotericin B is usually administered orally in the form of tablets, but injection solutions are also available. Both variants can effectively combat mild as well as severe to very severe infections. The drug can only treat acute fungal infections and is not suitable for prevention.

These infections include histoplasmosis and blastomycosis , infections with so-called yeast fungi can also be combated with amphotericin B. Molds of the Aspergillus fumigatus type are also susceptible to treatment with amphotericin B. Interactions with other drugs are not known. Larger, systemic diseases must not be treated with the use of amphotericin B. The drug is suitable for patients of all ages and may also be used with caution during pregnancy or breastfeeding .

Risks & side effects

Unfortunately, it is a drug with numerous side effects. Amphotericin B can cause permanent kidney damage. The severity of damage depends on the total amount of drug administered, therefore amphotericin B should be administered in the lowest possible doses (however, these may differ from patient to patient).Furthermore, amphotericin B can lead to fever or chills immediately after ingestion and cause nausea and vomiting . Headaches and shifts in the body’s electrolyte balance are also among the frequently observed side effects.

Liver damage and anemia occur less frequently. Muscle pain that cannot be precisely localized is less common. However, numerous side effects can either be reduced or completely eliminated by choosing the lowest possible dosage of amphotericin B at the beginning of treatment.