Liposomal Amphotericin B Usefulness in Critical Care Unit: A Review Study

Abstract

During the last 3 decades, the prevalence and variety of invasive fungal infections increased, especially in the critically ill patients thanks to advances in medical sciences, modification of the instruments, drugs, and protective-therapeutic methods. Such infections are administered by 4 pharmaceutical classes as follows: 1. Polyenes; 2. Azoles; 3. Echinocandins; 4. Pyrimidine analogues. One of these drugs is polyenes consisting of amphotericin and its lipid-based formulation. The lipid formulation of this drug is used due to its fewer side effects compared with the conventional type of the drug that makes it possible to enhance the drug efficacy by increasing the administered dosage. This pharmaceutical class is used to treat the following diseases in the critically ill patients: candidiasis, invasive aspergillosis, mucorales infection, cryptococcal meningoencephalitis, visceral leishmaniosis, persistent fever and neutropenia, renal replacement therapy (RRT) in intensive care unit (ICU), kidney transplantation, and liver problems. Now, the word health organization (WHO) approved liposomal amphotericin B (AmB) as the first-line treatment of visceral leishmaniosis in the Eastern Africa. It was even used with a single dose of 10 mg/kg with 95% efficacy. The current study aimed at investigating the effect of amphotericin and its lipid formulation to treat the aforementioned diseases.