An overview of the available treatments for chronic cavitary pulmonary aspergillosis.

Abstract:

INTRODUCTION:Chronic pulmonary aspergillosis (CPA) is a chronic lung infection caused by Aspergillus fumigatus, that complicates structural lung diseases. Of the different types of CPA, chronic cavitary pulmonary aspergillosis (CCPA) is the most common form. The mainstay of treatment of CCPA is oral triazoles. However, many gaps exist in clinical decision-making about the agent of choice, the duration, and the assessment of treatment response. AREAS COVERED:We discuss the approach to diagnosis and treatment of CCPA. We have searched the PubMed and EmBase databases (from inception till 31 October 2019) to identify studies describing the use of anti-fungal agents in CCPA. EXPERT OPINION:Treatment for CCPA should be initiated with oral itraconazole for at least six months. In case of poor response or intolerance to itraconazole, voriconazole should be considered. Intravenous agents, including amphotericin B and echinocandins, may be used in those with either treatment failure or those who are intolerant to oral antifungal agents. Posaconazole and isavuconazole may be used as salvage therapy due to a better pharmacokinetic/pharmacodynamic profile of the former and reduced drug-drug interactions with the latter.

journal_name

Expert Rev Respir Med

authors

Sehgal IS,Dhooria S,Muthu V,Prasad KT,Agarwal R

doi

10.1080/17476348.2020.1750956

subject

Has Abstract

pub_date

2020-07-01 00:00:00

pages

715-727

issue

7

eissn

1747-6348

issn

1747-6356

journal_volume

14

pub_type

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