The role of macrophage activation in the candidacidal activity of liposome-incorporated (L) amphotericin B was investigated. Macrophages treated with L-amphotericin B killed Candida albicans more effectively than did macrophages treated with free (F) amphotericin B. However, macrophages treated with neither F- nor L-amphotericin B killed amphotericin B-resistant Candida tropicalis. In vivo stim...

The development of newer antifungal drugs is creating new potential combination therapies to combat the dismal mortality rate associated with invasive aspergillosis (IA). The efficacy of combination therapy for IA has not been established; sparse data on combination or sequential antifungal therapy depict interactions ranging from synergy to antagonism. We reviewed data from all published in vi...

Emergence of resistance to antifungal drugs during therapy for invasive aspergillosis has received scant attention. We recovered Aspergillus isolates from six patients with invasive aspergillosis, who were receiving amphotericin B before fungal isolation. Although isolates were susceptible to amphotericin B in vitro, none of the patients survived. The MIC of amphotericin B for isolates was simi...

Amphotericin B lipid complex (ABLC) shows reduced toxicity relative to that of amphotericin B deoxycholate (AmB-d) while maintaining antifungal activity. Rat blood or plasma was spiked with ABLC in vitro. Released amphotericin B was separated from the parent material by centrifugation. At early times (0 to 15 min) most (approximately 90%) of the amphotericin B was complexed. The amount of relea...

Our purpose was to develop and characterize an enzyme-linked immunosorbent assay (ELISA) which could measure the concentration of amphotericin B in serum. Amphotericin B was assayed by competition ELISA. Multiwell ELISA plates coated with amphotericin B (1.0 micrograms/ml) conjugated to bovine serum albumin were used to test replicates of serum samples spiked with amphotericin B. Purified rabbi...

OBJECTIVES The aim of the present study was to evaluate the in vitro activity and synergism of the combinations of amphotericin B/caspofungin and amphotericin B/posaconazole against Candida albicans, grown either as planktonic cells or in biofilms. METHODS Ten C. albicans bloodstream isolates used in this study were collected from intensive care patients admitted to the Vienna University Hosp...

The ocular toxicity of liposome-intercalated amphotericin B and commercial amphotericin B were compared after intravitreal injection in healthy pigmented rabbits. Ophthalmoscopic observations over 5 weeks following a single intravitreal injection showed vitreal band formation and focal retinal damage after doses of commercial amphotericin B as low as 5 micrograms. Such lesions were not seen in ...

OBJECTIVE To compare available antifungal treatments for invasive candidiasis, a leading cause of nosocomial bloodstream infections. METHODS We performed a systematic review and meta-analysis of randomized controlled trials that compared different antifungal agents for the treatment of candidemia and other forms of invasive candidiasis. Two reviewers independently appraised the quality of tri...

Amphotericin B-3H with a specific radioactivity in excess of 4 muCi/mg was produced by fermentation of Streptomyces nodosus IMRU 3694 in a complex medium, using acetate-3H as a precursor. The medium employed gave a production yield of 2.5 approximately 3.5 mg/ml of amphotericin B. The most efficient incorporation of acetate-3H occurred when the precursor was added at 24 hours after inoculation....