Liposome-encapsulated amphotericin B: a promising new treatment for disseminated fungal infections.

Amphotericin B therapy is hampered by numerous adverse effects but remains the treatment of choice for disseminated fungal infections. A new form of amphotericin B delivery, which utilizes liposome vesicles, is currently under investigation. Preliminary evidence suggests that liposome-encapsulated amphotericin B has a wider therapeutic index than free amphotericin B and allows for the use of larger total doses. The mechanism of reduced toxicity and enhanced activity may be associated with a liposome donor effect, an erythrocyte protective effect, and a liposome-targeting ability. Liposome-encapsulated amphotericin B tends to be entrapped or taken up by organs rich in reticuloendothelial cells--a particular advantage since disseminated fungal infections localize in these areas. This liposome-encapsulated preparation appears to represent a promising new form of antifungal therapy that may reduce the dose-limiting toxicities of amphotericin B and improve treatment response.