In the Fall of 1999, we presented at medical “Grand Rounds” to a number of Infectious Diseases physicians
at Vancouver General Hospital about the co-administration of several antifungal compounds in the treatment
of blood-borne fungal infections to patients who were immunocompromised (i.e. cancer patients, patients
waiting organ transplantation, HIV/AIDs patients, etc.). During the presentation, a physician from the back of the
room called out “can you develop an oral formulation of amphotericin B which could be effective and not have
the side-effects associated with the parenteral formulations of the drug”. The physician stated that an oral formulation
would be a big step forward, improving patient compliance, helping in pre-treatment without admitting
patients to the hospital prior to organ transplantation and it would be cost-effective.
Initially, I responded to the physician, that it would not be possible to develop an oral amphotericin B formulation
that could be absorbed from the gastrointestinal (GI) tract in a high enough concentration to be effective in treating
blood-borne fungal infections and yet remains non-toxic due to the physical chemical properties of the drug.
However, as I travelled back to my lab from the meeting, it struck me that our understanding of how lipids had
been processed and orally absorbed from the GI had advanced to the point the maybe incorporating amphotericin
B into such lipids might work.
Within several years, our laboratory was able to develop a novel oral amphotericin B formulation that was indeed
effective in treating systemic fungal infections without the side-effects associated with the drug in a variety of
fungal animal models.