Clinical roundtable monograph: safety and efficacy of lipid-based amphotericin B.

Invasive fungal infections are an important cause of morbidity and mortality in critically ill and immunocompromised patients. Amphotericin B has remained the gold standard treatment for systemic fungal infections. The primary obstacle to amphotericin B therapy is its poor solubility and dose-related toxicities, especially renal impairment. As a result, newer lipid-based formulations of amphotericin B have been developed. This monograph compares available phamacokinetic, efficacy, and safety data for the 3 lipid-based formulations of amphotericin B, with reference to various patient populations. Potential causes of infusion-related reactions are described, and a premedication algorithm for the prevention of infusion-related reactions is developed.