Lipid-based antifungal agents: Current status

Immunocompromised patients are well known to be predisposed to developing i nvasive fungal infections. These infections are usually difficult to diagno se and more importantly, the resulting mortality rate is high. The limited number of antifungal agents available and their high rate of toxicity are t he major factors complicating the issue. However, the development of lipid- based formulations ol existing antifungal agents has opened a new era in an tifungal therapy. The best examples are the lipid-based amphotericin B prep arations, amphotericin B lipid complex (ABLC; Abelcet(R)), amphotericin B c olloidal dispersion (ABCD; Amphotec(R) or Amphocil(R)), and liposomal ampho tericin B (AmBisome(R)). These formulations have shown that antifungal acti vity is maintained while toxicity is reduced. This progress is followed by the incorporation of nystatin into liposomes. Liposomal nystatin formulatio n is under development and studies of it have provided encouraging data. Fi nally, lipid-based formulations of hamycin, miconazole, and ketoconazole ha ve been developed but remain experimental. Advances in technology of liposo mes and other lipid formulations have provided promising new tools for mana gement of fungal infections.