Amphotericin B is a polyene macrolide antifungal antibiotic, originally derived from Streptomyces bacteria, used to treat serious systemic fungal infections including candidiasis, aspergillosis, cryptococcosis, histoplasmosis, and mucormycosis. It exerts fungicidal activity by binding ergosterol, the dominant sterol…
Amphotericin B is a polyene macrolide antifungal antibiotic, originally derived from Streptomyces bacteria, used to treat serious systemic fungal infections including candidiasis, aspergillosis, cryptococcosis, histoplasmosis, and mucormycosis. It exerts fungicidal activity by binding ergosterol, the dominant sterol of the fungal plasma membrane, and forming pore-like channels that disrupt membrane integrity. The resulting loss of selective permeability allows efflux of potassium and other essential intracellular components, leading to fungal cell death; an additional oxidative mechanism may contribute. Its preferential binding to fungal ergosterol over mammalian cholesterol underlies selectivity, yet residual interaction with host membranes causes characteristic toxicity, particularly nephrotoxicity, electrolyte loss, and infusion-related reactions. Lipid and liposomal formulations were developed to reduce these effects and enable higher, more effective dosing. The broad antifungal spectrum and fungicidal action of amphotericin B make it a mainstay for aggressive and refractory mycoses, including the angioinvasive moulds of the order Mucorales responsible for mucormycosis, where prompt antifungal therapy is combined with surgical debridement and correction of predisposing conditions. Its mechanism remains a benchmark for evaluating newer agents and natural antifungal compounds, and it informs studies of resistance and combination therapy. Amphotericin B continues to be a cornerstone of treatment for invasive and opportunistic fungal disease, especially in immunocompromised patients.
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