Which of the following antifungals is known for its risk of infusion-related reactions?

Amphotericin B is known for its risk of infusion-related reactions, which can occur due to the drug's mechanism of action and its effects on the body. Amphotericin B is a polyene antifungal that binds to ergosterol in fungal cell membranes, leading to cell membrane disruption and subsequent cell death. Unfortunately, this also triggers a range of immune responses, which can cause symptoms such as fever, chills, muscle spasms, vomiting, and headache during the infusion.

These infusion-related reactions are more pronounced with the amphotericin B formulation compared to other antifungal agents, as it can release cytokines that provoke an inflammatory response. To manage these reactions, premedication with antipyretics or corticosteroids is often employed.

In contrast, other antifungals listed do not have the same level of infusion-related side effects associated with their administration. Fluconazole and voriconazole, both azole antifungals, are generally well tolerated and associated with fewer acute infusion reactions. Terbinafine, typically used for topical antifungal treatment, is not administered intravenously and thus is not associated with infusion-related reactions. Therefore, amphotericin B stands out as the antifungal with a notable risk of infusion-related reactions