Polyene macrolids

Polyenes

Polyene macrolides like amphotericin B, amphotericin B (liposomal) and nystatin bind ergosterol in the fungal cell membrane, thereby forming a

pore. This pore allows the cell content to leak out of the fungus, ultimately leading to fungal cell death. Amphotericin has minimal oral absorption and should therefore be given intravenously. A patient can develop fever and chills as an acute reaction to intravenous administration. Patients receiving amphotericin therapy for deep mycoses get azotemia in 80% of the cases.

Amphotericin is used for a wide range of systemic fungal, yeast and mould infections including Histoplasma, Blastomyces, Coccidiomycosis and together with flucytosine for Cryptococcol meningitis.

1

Adverse effects of polyenes are due to binding of the drug to cholesterol on human cells.

2

Amphotericin is given oral in severe infections with Candida or Aspergillus species.