Introduction

Name

• Amphotericin B.

Class of drug

• Polyene antifungal antibiotic.

Description

Molecular formula

• C47H73NO17.

Physical properties

• Yellow powder/tablets or solution.
• Injectable: 50 mg/vial powder for reconstitution.

Storage requirements

• After reconstitution the preparation is stable for 1 week if refrigerated and stored in the dark.
• Keep in the dark, however, the loss of drug activity is negligible for at least 8 hours in room light.

Uses

Indications

• Advanced systemic mycoses.
• Management of leishmaniosis in other species.
• Fungal septicemia.
• Fungal urinary tract infections.
• Candida is particularly susceptible to this medication.

Administration

Pharmacokinetics

Precautions

Interactions

with other drugs

• Amphotericin B may increase the toxic effects of cisplatin, fluorouracil, docorubicin and methotrexate.
• Flucytocine (flucytosine) is synergistic with amphotericin Bin vitroagainstCandida,CryptococcusandAspergillus.

Adverse Reactions

Further Reading

Publications

Refereed papers

• Recent references from PubMed and VetMedResource.
• Krautwald-Junghanns M E, Vorbrüggen S, Böhme J (2015) Aspergillosis in birds: An overview of treatment options and regimes. J Exotic Pet Med 24 (3), 296-307 ResearchGate.
• Ziołkowska G, Tokarzewski S & Nowakiewicz A (2014) Drug resistance of Aspergillus fumigatus strains isolated from flocks of domestic geese in Poland. Poultry Sci 93 (5), 1106-1112 PubMed.
• Deren Y T, Ozdek S, Kalkanci A et al (2010) Comparison of antifungal efficacies of moxifloxacin, liposomal amphotericin B, and combination treatment in experimental Candida albicans endophthalmitis in rabbits. Can J Microbiol 56 (1), 1-7 PubMed.
• Silvanose C D, Bailey T A & Di Somma A (2006) Susceptibility of fungi isolated from the respiratory tract of falcons to amphotericin B, itraconazole and vorconazole. Vet Rec 159 (9), 282-284 PubMed.
• Cannon J P, Fiscella R, Pattharachayakul S et al (2003) Comparative toxicity and concentrations of intravitreal amphotericin B formulations in a rabbit model. Invest Ophthal Vis Sci 44 (5), 2112-2117 PubMed.
• Petraitis V, Petraitiene R, Groll A H et al (2002) Comparative antifungal activities and plasma pharmacokinetics of micafungin (FK463) against disseminated candidiasis and invasive pulmonary aspergillosis in persistently neutropenic rabbits. Antimicrobial Agents Chemo 46 (6), 1857-1869 PubMed.
• Sanati H, Ramos C F, Bayer A S et al (1997) Combination therapy with amphotericin B and fluconazole against invasive candidiasis in neutropenic-mouse and infective-endocarditis rabbit models. Antimicrobial Agents Chemo 41 (6), 1345-1348 PubMed.
• Christiansen K J, Bernard E M, Gold J W et al (1985) Distribution and activity ofamphotericin B in humans. J Infect Dis 152 (5), 1037-1043 PubMed.
• Arroyo J C (1984) Amphotericin B fever in rabbits. Life Sci 34 (13), 1249-1252 PubMed.

Other sources of information

• Meredith A (2015) BSAVA Small Animal Formulary. Part B: Exotic Pets. 9th edn. Gloucester, BSAVA. pp 20-21.
• Hedley J (2014) Respiratory Disease. In:BSAVA Manual of Rabbit Medicine. Eds: Meredith A & Lord B.  BSAVA, Gloucester.  pp 160-167.