Question

Amphotericin B toxicity can be lowered by:

• A. Giving it with glucose
• B. Decreasing the dose
• C. Using liposomal delivery systems
• D. Combining with flucytosine

Hint:

Lipid carriers steer amphotericin away from the kidney, cutting its main toxicity.

Answer 1

The Correct Option is C

Step 1: Conventional amphotericin B (deoxycholate form) is a highly effective but toxic antifungal. Its main toxicities are dose-dependent nephrotoxicity, infusion-related fever and rigors, hypokalemia and anemia. The question asks how to lower this toxicity.

Step 2: Liposomal and other lipid formulations package the drug in lipid carriers. These preferentially deliver the drug to fungal cell membranes and to the reticuloendothelial system while sparing the kidney, so nephrotoxicity is markedly reduced even at higher effective doses. So option C is correct.

Step 3: Giving it with glucose (A) relates to how the infusion is prepared and does not reduce its intrinsic organ toxicity. So A is wrong.

Step 4: Decreasing the dose (B) would lower toxicity but would also lower efficacy, so it is not the recommended way to make the drug safer while keeping it effective. The question seeks the strategy that reduces toxicity without sacrificing the cure, which is the lipid formulation. So B is not the best answer.

Step 5: Combining with flucytosine (D) is done to gain synergy and allow a lower amphotericin dose in some infections, but flucytosine itself adds bone marrow toxicity and is not primarily a toxicity-reducing measure. So D is a weaker answer than C.

Conclusion: The best way to lower amphotericin B toxicity is to use liposomal delivery systems, option C.