Use of amphotericin B aerosols for the prevention of pulmonary aspergillosis.
Invasive pulmonary Aspergillus infections are increasingly recognized among severely neutropenic and/or immunosuppressed individuals. As the infections are usually acquired through the inhalation of Aspergillus conidia, at present prevention of invasive pulmonary aspergillosis consists mainly of the reduction of environmental exposure to aspergillus conidia. More recently, prophylaxis with amphotericin B aerosols has been investigated. Inhalations with amphotericin B aerosols significantly delayed mortality in an animal model of invasive pulmonary aspergillosis and high pulmonary concentrations of amphotericin B could be achieved. In man, pulmonary deposition of amphotericin B could also be demonstrated using commercially available nebulizers. Inhalations were well tolerated with little systemic absorption of the drug. In order to evaluate the efficacy of aerosol amphotericin B administrations for the prevention of invasive pulmonary aspergillosis, a prospective randomized trial has been initiated.
Beyer
J
J
Abteilung für Hämatologie/Onkologie, Universitätsklinikum Rudolf Virchow, Freien Universität Berlin, Germany.
Schwartz
S
S
Barzen
G
G
Risse
G
G
Dullenkopf
K
K
Weyer
C
C
Siegert
W
W
D000336:Aerosols; D000666:Amphotericin B / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use*; D000818:Animals; D001228:Aspergillosis / Q000188:drug therapy* / Q000209:etiology; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D002986:Clinical Trials as Topic; D004195:Disease Models, Animal; D004353:Drug Evaluation, Preclinical; D006801:Humans; D008172:Lung Diseases, Fungal / Q000188:drug therapy* / Q000209:etiology; D009503:Neutropenia / Q000209:etiology; D010316:Particle Size; D011446:Prospective Studies; D051381:Rats; D014018:Tissue Distribution
D000336:Aerosols; D000666:Amphotericin B