Antibiotic uses of four commercially available polyenes

ANTIBIOTIC USES OF FOUR COMMERCIALLY AVAILABLE POLYENES Nystatin 

The therapeutic use of nystatin has been reviewed [409,420]. This antibiotic has been used successfully in the treatment of monilial infections of the skin, nails and mucosal surfaces. Nystatin given orally rapidly clears candidosis of the 

Prolonged intravenous amphotericin B therapy has been shown to produce haemolytic anemia and renal damage. Although polyene antibiotics are known to lyse erythrocytes in vitro, it is not thought that in vivo lysis caused the observed anemia (see p. 150) but resulted from inhibition of bone marrow erythrocyte synthesis [353]. 

Prolonged therapy with amphotericin B may lead to kidney damage, which may be irreversible [429]. Nephrotoxicity and hypokalemia are the major 

Renal tubular acidosis can occur during amphotericin B therapy [439,440]. Renal tubular acidosis and hykalemia can be easily corrected with oral potassium therapy [436,439,441]. Hydrocortisone and heparin are sometimes used in conjunction with polyene therapy to reduce toxic side effects [442]. The immediate reactions to intravenous amphotericin B therapy (nausea, vomiting and fever) can be controlled to some extent by usually antihistamines and hydrocortisone [443,444] but reports that some of the symptoms of nephrotoxicity may be overcome by mannitol supplementation [445] have been disputed [446]. 

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