Novas formas comerciais de anfotericina B
Palabras clave:
anfotericina B, infecções, micosesResumen
A anfotericina B permanece como o padrão ouro para o tratamento de infecções fúngicas invasivas. Para melhorar a eficácia terapêutica desse fármaco e reduzir sua toxicidade aguda e crônica, diversas formulações lipídicas de anfotericina B foram desenvolvidas, entre elas: anfotericina B lipossômica (AmBisome®), complexo lipídico de anfotericina B (ABLC, Abelcet®) e dispersão coloidal de anfotericina B (ABCD, Amphocil®). Essas novas formulações são efetivas em várias infecções fúngicas sistêmicas, incluindo candidíase, aspergilose invasiva, mucormicose, criptococose, fusariose, sendo também eficientes no tratamento de leishmaniose. As três formulações apresentam baixa toxicidade renal, sendo mais seguras que a anfotericina B convencional. Raros são os trabalhos que comparam as formulações lipídicas. Estudos de triagem clínica em ampla escala podem esclarecer a eficácia relativa em várias formas de infecções fúngicas. A presente revisão analisa os dados disponíveis na literatura, faz uma comparação entre as três formulações lipídicas e discute a questão custo e benefício do tratamento para o paciente.
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