Shortage of injectable amphotericin B

The American Society of Health-System Pharmacists reports a shortage of injectable amphotericin B. This drug is typically used for severe fungal infections in people whose immune system is not functioning well for various reasons. This particular formulation has potentially severe side effects, most often because it is very toxic to the kidneys. Two newer and more expensive formulations better protect the kidneys and other organs, but may not work as well to control an infection. Amphotericin B is the drug of choice for meningitis caused by a fungus called cryptococcus, and the drug of last resort to prevent death due to the protozoans that cause amebic meningoencephalitis and visceral leishmaniasis. Since the action of amphotericin B depends on the presence of ergosterol in fungal cell membranes, a notable exception is that it will not work on the cholesterol-containing membranes of the fungus, Pneumocystis carinii, so often associated with the Acquired Immune Deficiency Syndrome.