Fungi are everywhere around us, some of them are harmless to the body, and the other part will take the opportunity to make trouble when our immunity is reduced, causing fungal infections and diseases. For people with low immunity, such as HIV carriers, elderly people with declining health, and immunosuppressed patients.
Fungal infections are common in life, but most of them belong to superficial fungal infections such as skin and mucous membranes. Under normal circumstances, your body can completely cope with it by itself, even without drug intervention. Of course, this rarely kills people, but if there is a deep fungal infection, it will be terrible, and the diagnosis of fungal infection is difficult, so before the 1950 s, it was basically helpless to encounter invisible bacterial meningitis and other spinach fungal infections.
This situation was broken by the launch of Amphotericin B in 1958, which greatly improved the prognosis of deep fungal infections in clinical practice. Amphotericin B is a polyene antifungal antibiotic, which is refined by scientists from the culture medium of streptomyces. It combines with the sterols on the fungal cell membrane to destroy the permeability of the fungal cell membrane, resulting in the leakage of potassium ions, nucleotides, amino acids, etc. in the bacterial cell, breaking the normal metabolism and playing a bacteriostatic role. Used for systemic infections caused by Cryptococcus, coccidiospores, Candida, Mucor, Aspergillus, etc.
Although fungi belong to microorganisms, they belong to eukaryotic cells, and most of them are the same as or similar in function to human cells. Therefore, when inhibiting the synthesis and replication of fungal DNA, other cells in the human body will also suffer from accidental injury. As the saying goes, if you hurt 1000 the enemy, you will lose 800. Although amphotericin B has a good effect on fungi, it has serious side effects, especially when you take intravenous drugs, you should closely monitor it.
It may cause chills, high fever, headache, nausea, vomiting, etc. during intravenous drip, and almost all Almost all will have different degrees of renal function damage after medication. So when using medication, attention should be paid to controlling the infusion rate. Generally, each intravenous infusion takes 4-6 hours, and regular monitoring of liver and kidney function, electrolyte and other indicators is also necessary.
Clinicians love and hate Amphotericin B both. Especially in the 1990s, the listing of azoles and other antifungal drugs provided doctors with more choices, and Amphotericin B was gradually not the first choice. However, it was later found that although azoles have little impact on renal function and can be taken orally, they are fungal inhibitors, and their bactericidal effect is not as strong as that of Amphotericin B. Therefore, Amphotericin B is still used for fatal fungal infection in critical condition.
Market Prospect
Amphotericin B powder has many side effects and adverse reactions, but it is the only effective treatment for some fatal invasive fungal infections. In order to reduce the side effects of Amphotericin B, scientists have been studying and modifying Amphotericin B to reduce toxicity. At present, there are Amphotericin B liposomes, Amphotericin B cholesterol complex, Amphotericin B Deoxycholic acid salt and other formulations. It is believed that there will be better and safer antifungal Drug development in the future.
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