Liposomal Amphotericin B Formulations in Antifungal Therapy

Liposomal amphotericin B represents a pivotal advance in antifungal chemotherapy, combining the potent polyene amphotericin B with phospholipid vesicles to enhance therapeutic index. Encapsulation within liposomes modifies biodistribution, permitting targeted delivery to infected tissues while substantially reducing nephrotoxicity and infusion-related adverse events associated with conventional deoxycholate formulations. These lipid-based carriers improve drug solubility, prolong circulation time and facilitate passage across biological barriers, thereby broadening clinical applications in systemic and central nervous system fungal infections. As invasive fungal disease incidence rises globally—particularly among immunocompromised populations—liposomal amphotericin B has become the preferred option for severe and refractory cases, including mucormycosis, cryptococcal meningitis and multidrug-resistant Candida species. Ongoing innovation in particle design and dosing regimens aims to optimise efficacy, minimise residual toxicity and extend utility in resource-limited settings.

Research from Nature Portfolio

Recent analyses of large patient cohorts have elucidated risk factors for acute kidney injury during liposomal amphotericin B therapy. Retrospective data across multiple centres revealed that prior use of angiotensin-converting enzyme inhibitors or receptor blockers, concurrent administration of catecholamines or immunosuppressants and dosing above a critical threshold significantly increase the likelihood and severity of renal injury. Pre-treatment electrolyte status, notably hypokalaemia, further predisposes to advanced nephrotoxicity. These findings support stratified dosing strategies, rigorous electrolyte monitoring and careful selection of concomitant medications to mitigate renal complications without compromising antifungal efficacy.

Liposomal Amphotericin B Formulations in Antifungal Therapy publication trend

The graph below shows the total number of articles in liposomal amphotericin b formulations in antifungal therapy across all publications each year (not limited to Nature Index journals).

Technical terms

Liposomal amphotericin B: Amphotericin B encapsulated within lipid vesicles to alter pharmacokinetics and reduce toxicity.

Nephrotoxicity: Kidney injury caused by a drug or other chemical agent, often manifesting as elevated serum creatinine or reduced glomerular filtration.

Pharmacokinetics: Study of drug absorption, distribution, metabolism and excretion over time.

Invasive fungal infections: Serious infections caused by pathogenic fungi that invade sterile body sites such as the bloodstream, lungs or central nervous system.

References

1. Factor analysis of acute kidney injury in patients administered liposomal amphotericin B in a real-world clinical setting in Japan. Scientific Reports (2020).
2. A Real-World Data Observational Analysis of the Impact of Liposomal Amphotericin B on Renal Function Using Machine Learning in Critically Ill Patients. Antibiotics (2024).
3. Amphotericin B in the Era of New Antifungals: Where Will It Stand?. Journal of Fungi (2024).
4. Association between fluid infusions and the recovery from acute kidney injury in patients administered liposomal amphotericin B: a nationwide observational study. Renal Failure (2022).