ABSTRACT
INTRODUCTION For decades, polyene antifungals have been mainstays for the prevention and treatment of invasive fungal infections (IFIs). However, because nystatin is restricted to topical (nonsystemic) administration, its application as prophylaxis against IFI in selected high-risk patients has largely been replaced by alternate strategies. Similarly, treatment with nystatin is restricted to mucocutaneous forms of candidiasis (such as oropharyngeal, cutaneous, mucocutaneous, and vulvovaginal infections). Investigations with lipid-based formulation of nystatin for systemic use have not yet yielded a commercial product (1). In contrast, amphotericin B has been a mainstay for the prevention and treatment of IFIs since 1957 (2). While less frequently employed today as prophylaxis (given the expanded availability of safer alternatives), amphotericin B [administered intravenously as either amphotericin B deoxycholate (AmBd) or one of three lipid-based formulations (LBFAmB)] is still considered a treatment option in select cases of severe or life-threatening IFIs (2-11).
