Lipid-based amphotericin B formulations: from animals to man

Amphotericin B has been the mainstay of systemic antifungal therapy for ove r 30 years, despite its serious side-effects, and, although numerous altern ative antifungal agents have been developed, none to date has matched the e fficacy of amphotericin B. However, modern drug delivery technology has imp roved the safety of amphotericin B by incorporating it into lipid-based del ivery systems, including liposomes. Three such formulations, based on the n atural affinity of amphotericin B for lipids, are currently marketed. All i ncrease the therapeutic index of amphotericin B, thereby allowing more aggr essive treatment than is possible with the conventional product. However, t hey differ in structure, side-effect profiles and evidence of proven effica cy as discussed in this review.