The Management of Chronic Pulmonary Aspergillosis: The UK National Aspergillosis Centre Approach.

TitleThe Management of Chronic Pulmonary Aspergillosis: The UK National Aspergillosis Centre Approach.
Publication TypeJournal Article
Year of Publication2017
AuthorsMaghrabi, F, Denning, DW
JournalCurr Fungal Infect Rep
Volume11
Issue4
Pagination242-251
Date Published2017
ISSN1936-3761
Abstract

Purpose of Review: Chronic pulmonary aspergillosis (CPA) is a serious long-term fungal disease of the lung with a worldwide prevalence. Treatment of CPA is not straightforward given the often-multiple associated co-morbidities, complex clinical picture, drug interactions, toxicities and intolerances.

Recent Findings: First line treatment is oral itraconazole or voriconazole. In the event of intolerance or toxicity, patients may be swapped from itraconazole to voriconazole or vice versa. In the event of resistance or further intolerance, third line treatment with posaconazole could be initiated. In those with pan-azole resistance, short-term courses of intravenous liposomal amphotericin B or micafungin are fourth line therapy, keeping in mind the nephrotoxic effects of amphotericin B.

Summary: The available evidence for current treatments in CPA is limited and based mostly on retrospective cohort studies. There is a real need to raise awareness of this devastating disease to enable early treatment as well as prospective drug trials and studies to identify potential patient factors that correlate with progression, severity and overall outcomes in order to target future therapies.

DOI10.1007/s12281-017-0304-7
Alternate JournalCurr Fungal Infect Rep
PubMed ID29213345
PubMed Central IDPMC5705730