Amphotericin B colloidal dispersion (ABCD) is a near 1:1 discoidal complex
of amphotericin B (AMB) and sodium cholesteryl sulfate (SCS) arranged as a
bilayer of SCS interspersed with AMB via noncovalent interactions. The comp
lex is stable in blood and plasma with minimal dissociation. In vitro and i
n vivo studies show that ABCD is as effective and four to five times safer
than conventional AMB (CAB) for fungal infection. Compared with CAB treatme
nt, ABCD demonstrates reduced peak plasma levels, prolonged residence time,
and lowered AMB levels in most tissues including kidney, the major target
of toxicity for CAB. In 572 patients with systemic fungal infections second
ary to severe underlying disease, ABCD doses less than or equal to6 mg/kg/d
ay were well tolerated, even in those who failed to tolerate or respond to
CAB. Mild-to-moderate, dose-dependent, infusion-related adverse events typi
cally seen with CAB were also observed with ABCD, with no sign of renal or
hepatic toxicity. Complete or partial recovery was seen in 57.3%. Therefore
, ABCD should be considered as an alternative treatment Of systemic fungal
infections. (C) 2001 Elsevier Science B;V. All rights reserved.