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.
Adverse effects of polyenes are due to binding of the drug to cholesterol on human cells.
Extra info: Ergosterol and cholesterol are very similar structures and polyenes can thus bind to both compounds. Although polyenes can have effects on other systems in the body.
Amphotericin is given oral in severe infections with Candida or Aspergillus species.
Extra info: Amphotericin is given via i.v. infusion in severe Candida or Aspergillus infections