Fungal skin lesions bring significant discomfort to the patient. Moreover, such diseases are contagious. Therefore, when the first signs of a fungus appear, you should definitely contact a narrow specialist. After passing medical tests and other examinations, the doctor must prescribe effective medications to the patient.
Very often, various ointments and tablets are used to treat fungal diseases. However, most doctors argue that such a pathological condition is best treated with intravenous injection. After injections, the drug will immediately begin to affect microorganisms that are especially sensitive to it.
The most effective and effective means for eliminating fungal diseases include the drug "Amphotericin B". Instructions, release forms and reviews about this medicine will be presented below.
Form, composition, description and packaging of the antibiotic
You can buy the drug in the following forms:
- Lyophilisate "Amphotericin B". Reviews report that this form of the drug is a yellow porous hygroscopic mass without a pronounced odor. It is intended for the preparation of an infusion solution. The active component of this medication is amphotericin B. As auxiliary components, substances such as monosubstituted sodium phosphate and deoxycholic acid are used. On sale, this medication comes in 10 ml vials and packs of cardboard.
- Ointment "Amphotericin B". The use of this tool is indicated as an additional drug in complex therapy. Antifungal ointment is used only externally. It has a yellow color and contains the same active substance. As for the additional components, they are used as liquid paraffin, medical paraffin and polysorbate 80. You can buy this medication in tubes of 30 or 15 g.
The mechanism of action of the antifungal drug
What is the medicine "Amphotericin B"? Instructions for use (tablets with the same active substance are rather difficult to find) reports that this is a macrocyclic polyene antibiotic with antifungal activity. It is produced by Streptomyces nodosus, and also has a fungistatic and fungicidal effect (depending on the concentration of the drug in biological fluids and the sensitivity of the pathogen).
After the drug enters the bloodstream, it binds to sterols, which are located in the cell membranes of the drug-sensitive fungus. As a result of this effect, their permeability is disrupted and intracellular components are excreted into the extracellular space.
Amphotericin B is active against many strains and moderately active against protozoa.
It should also be noted that Fusarium spp is resistant to this agent. and Pseudallescheria boydii. In addition, this drug is ineffective against rickettsia, bacteria and viruses.
Kinetic properties of the drug
Now you know what an antifungal drug is, such as Amphotericin B. The mechanism of action of this tool has been described above.
After intravenous administration of the drug in a single dose in the blood, its effective concentration is immediately created, which remains throughout the day. With plasma proteins, this tool binds to 90 percent.
The medication in question is distributed in the liver, lungs, kidneys, spleen, muscles, adrenal glands and in other organs and tissues. Its concentration in pleural effusion, synovial and peritoneal fluids, as well as aqueous humor reaches 2/3 of the concentration in the blood.
The metabolic pathways of this drug are unknown. In urine and bile, about 98 percent of the drug is present as metabolites. It is excreted slowly through the kidneys. The initial half-life of the drug in adults is 24 hours, in children - 6-40 hours, and in newborns - 20-60 hours. The final half-life is 15 days.
Antibiotic indications
What diseases does the medicine Amphotericin B treat? It is prescribed for progressive, life-threatening fungal infections that were caused by sensitive microorganisms:
- histoplasmosis, disseminated cryptococcosis, coccidioidosis;
- cryptococcal meningitis, paracoccidioidosis, chromomycosis;
- meningitis caused by other fungi, North American blastomycosis;
- disseminated and invasive aspergillosis, ficomycosis (zygomycosis);
- disseminated form of candidiasis, hyalogifomycosis;
- mold mycosis, chronic mycetoma;
- disseminated sporotrichosis, infections of the abdominal cavity (including peritonitis);
- endophthalmitis, endocarditis, fungal sepsis;
- visceral leishmaniasis, fungal infections of the urinary tract;
- American cutaneous visceral leishmaniasis.
Antifungal contraindications
Consider which conditions prohibit the use of the drug "Amphotericin B" (tablets from a fungus with the same name are not produced). According to the instructions, this tool is contraindicated:
- in chronic renal failure;
- with hypersensitivity;
- during breastfeeding.
With caution, this medication is used for kidney diseases (including glomerulonephritis), amyloidosis, liver cirrhosis, hepatitis, anemia, agranulocytosis, pregnancy and diabetes mellitus.
Lyophilisate "Amphotericin B": instructions for use
To prepare an intravenous solution, the drug is used with an initial concentration of 5 mg / ml. Using a sterile syringe, 10 ml of water for injection is added to the medication bottle. Then its contents are shaken until a clear colloidal liquid is formed.
Intravenously, the drug is administered for half an hour under the control of blood pressure, body temperature and pulse of the patient. With good drug tolerance, its recommended daily dosage is 0.25-0.3 mg per kg of weight (depending on the severity of the disease).
For diseases of the heart and blood vessels, hypersensitivity and insufficient kidney function, treatment begins with small doses (5-10 mg), which are gradually increased by 5-10 mg per day and adjusted to 0.5-0.7 mg per kg.
With sporotrichosis, the course dose of the drug is 2.5 g, and the duration of therapy is at least 9 months.
With aspergillosis, the dosage of this drug is 3.6 g, and the duration of treatment is at least 11 months.
Children at the very beginning of therapy are injected with 0.25 mg per kg of body weight per day, and then gradually increase to the maximum dose (1 mg per kg).
Ointment "Amphotericin B": instructions for use
Tablets under the same brand name are not sold in pharmacies. Therefore, to replace this medication, you should consult a doctor.
If it is necessary to use Amphotericin B ointment, a thin layer is applied to the affected areas twice a day. The treatment course depends on the available indications:
- with candidiasis of skin folds - about 1-3 weeks;
- with diaper rash in children - about 7-14 days;
- with paronychia and lesions of the interdigital spaces - 2-4 weeks.
Side effects
The drug "Amphotericin B" can cause the following side effects:
- headaches, cramps, peripheral neuropathy, transient vertigo, encephalopathy;
- decreased appetite, vomiting, dyspepsia, nausea, gastralgia, diarrhea, hepatotoxicity, acute liver failure, jaundice, hepatitis, melena, hemorrhagic gastroenteritis;
- normochromic normocytic anemia, leukopenia, blood coagulation disorder, thrombocytopenia, agranulocytosis, hemolytic anemia, eosinophilia, leukocytosis;
- visual impairment, hearing loss, diplopia, tinnitus;
- tachypnea, shortness of breath, pulmonary edema, arrhythmia and allergic pneumonitis;
- decrease or increase in blood pressure, itching, ECG changes, cardiac arrest, shock, heart failure;
- anaphylactoid reactions, sneezing, nephrogenic diabetes insipidus, bronchospasm, nephrocalcinosis, rash, exfoliative dermatitis, toxic epidermal necrolysis
- impaired renal function, hypokalemia, hypostenuria, renal tubular acidosis, Stevens-Johnson syndrome, acute renal failure, oliguria, anuria;
- thrombophlebitis and burns at the injection site;
- fever, myalgia, weight loss, arthralgia, general weakness.
Overdose cases
When maintaining large doses of the drug, the patient may experience respiratory arrest and heart failure. Therefore, in the process of therapy, the dosages recommended by the doctor should be strictly adhered to. It is also necessary to control the work of respiratory and cardiac activity, the function of the kidneys and liver, the picture of peripheral blood, as well as the content of electrolytes in it.
Compatibility with other medicines
The drug "Amphotericin B" can enhance or weaken the effect of other drugs, as well as increase their toxicity. In this regard, this medication is prescribed with caution in complex therapy.
When prescribing the aforementioned funds, the patient should definitely notify his doctor about taking other drugs. Otherwise, the use of Amphotericin B (intravenous) can adversely affect a person’s health and general well-being.
Special recommendations
- Amphotericin B should only be used to treat life-threatening and progressive fungal infections.
- With prolonged use, the likelihood of developing toxic effects increases.
- If anemia occurs, the use of the drug should be discontinued.
Reviews
Now you know how Amphotericin B works. Suspension with this name is not sold in pharmacies. Therefore, for oral administration, you should choose another medication with a similar effect.
According to most patients, the drug in question effectively copes with the task. It perfectly treats fungal skin lesions, eliminating the physical and psychological discomfort of the patient.
The main disadvantage of this drug is the presence of a large number of side effects. During treatment with this agent, undesirable reactions can occur on the part of any organs and systems. Therefore, it should be used only for special indications.