Clinical and neuropathologic effects of chronically administered intravenous (iv)
amphotericin B methyl ester (
AME) were observed in 3 male dogs (2 German shorthaired pointers and 1 pit bull). Each dog received 6.2-7.3 g of
AME (299-327 mg/kg
body weight) over a period of 11-12 weeks. One dog developed
neurologic signs of severe diffuse brain dysfunction and at necropsy all 3 dogs had a marked
leukoencephalopathy, most severe in centrum ovale and subcortical white matter of frontal lobes. Brain histopathology included diffuse myelin loss, oligodendrocyte depletion, accumulation of macrophages filled with sudanophilic
lipid, fibrillary
astrogliosis, and swelling or fragmentation of many axons. Two control dogs administered iv
glucose showed no neuropathologic abnormalities. These findings closely resemble the clinical and neuropathologic abnormalities that developed in patients during the first human trial of
AME for treatment of
fungal infections, but differ from those of animal studies that did not closely simulate the long-term
drug administration required for antifungal
therapy in humans. It was concluded that before human clinical trial is authorized, experimental protocols for animal studies of
drug toxicity should reflect the anticipated human use of the
drug, both in dose and duration.