Topical Amphotericin B for Bacterial Vaginosis

What is Bacterial Vaginosis?

Bacterial vaginosis is a common infection of the vagina caused by an overgrowth of bacteria in the vagina. It is the most common condition for women, specifically women in their reproductive years. It is estimated that one in every three American women will get bacterial vaginosis and it is one of the most common reason women visit gynecology clinics. While bacterial vaginosis can resolve on its own without any medications, many lead to serious complications like ectopic pregnancy, pelvic inflammatory disease, or can even make women susceptible to sexually transmitted infections. Most of the time, bacterial vaginosis can successfully be treated with a short course of oral or topical antibiotics. However, topical formulation of amphotericin B is often prescribed to treat bacterial vaginosis that failed to respond to other recommended treatments.

What is amphotericin B and how does it work?

Amphotericin B is a medication that is also known as Ambisome®. It is an antifungal used to treat various fungal infections in human.

Amphotericin B works by altering the cell permeability through the process of binding to cholesterols of the cell membrane and disrupt the membrane stability. This causes leakage of intracellular components and ultimately leads to cell death.

Why do I need topical formulation of amphotericin B?

Amphotericin B is commercially available as lipid formulation that comes in a vial and is typically administered intravenously to treat severe systemic fungal infections. While bacterial vaginosis is an infection localized to the vagina, doctors often prescribe topical formulation of amphotericin B as a treatment therapy to minimize the adverse side effects of intravenous.

Where can I get topical formulation of amphotericin B?

Topical formulation of amphotericin B will not be available at your local retail pharmacies and will only be available at specialty compounding pharmacies. These specialty pharmacies can prepare medication into different formulations to meet the specific needs of an individual that cannot be found commercially. With compounding, amphotericin B can be formulated as vaginal suppositories, or cream that is administered intravaginally.

If you are looking for a place to compound your amphotericin B, you can contact Carefirst Specialty Pharmacy that is located at 400 Fellowship Road, Mount Laurel Township, NJ 08054. Phone: 844-822-7379

References

1. Amphotericin B. Prescribing Information. Astella Pharma US, Inc. 2012.
2. Pappas PG, Kauffman CA, Andes DR, et al. Clinical practice guideline for the management of candidiasis: 2016 update by the Infectious Diseases Society of America. Clin Infect Dis. 2016;62(4):e1-e50. doi: 10.1093/cid/civ933.