Aerosolized antifungals for the prevention and treatment of invasive fungal infections


Journal Article

Invasive fungal infections result in significant morbidity and mortality, most notably in immunosuppressed patients. Aerosolized antifungal agents have been utilized primarily as prophylaxis (either alone or in combination with systemic antifungals) in patients at highest risk of invasive infections in attempts to optimize drug delivery while minimizing the potential for systemic toxicity and/or drug interactions. Published clinical experience with aerosolized antifungals most frequently involves various formulations of the polyene amphotericin B in patients undergoing lung transplantation and/or select patients with hematologic malignancy. Adverse events are infrequent and generally limited to dyspnea, dysgeusia, and cough. Existing data suggests lipid-based amphotericin B formulations may be better tolerated than amphotericin B deoxycholate. Published clinical experience with aerosolized antifungals as adjunctive treatment of invasive fungal infections is limited to case reports. Currently, there is insufficient evidence to support use of aerosolized echinocandins and azoles in clinical practice. Outstanding questions regarding comparative efficacy, optimal dose, duration and drug delivery present a continuing challenge when utilizing these agents in clinical practice. © 2013 Springer Science+Business Media New York.

Full Text

Duke Authors

Cited Authors

  • Dimondi, VP; Drew, RH

Published Date

  • June 1, 2013

Published In

Volume / Issue

  • 7 / 2

Start / End Page

  • 110 - 118

Electronic International Standard Serial Number (EISSN)

  • 1936-377X

International Standard Serial Number (ISSN)

  • 1936-3761

Digital Object Identifier (DOI)

  • 10.1007/s12281-013-0137-y

Citation Source

  • Scopus