Current pharmacotherapy of allergic bronchopulmonary aspergillosis.
Although no well-designed studies have been carried out, the available data support the use of corticosteroids for acute exacerbations of allergic bronchopulmonary aspergillosis (ABPA). Neither the optimal steroid dose nor the duration of therapy has been standardised but limited data suggest the starting dose should be prednisone (approximately 0.5 mg/kg/day). The decision to taper steroids should be made on an individual basis, depending on clinical course. The available data suggest that clinical symptoms alone are inadequate to make such decisions, since significant lung damage may occur in asymptomatic patients. Increasing serum IgE levels, new or worsening infiltrate on chest radiograph and worsening spirometry suggest that steroids should be used. Multiple asthmatic exacerbations in a patient with ABPA suggest that chronic steroid therapy should be used. Itraconazole appears useful as a steroid sparing agent.
Judson
M A
MA
Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston, USA.
Stevens
D A
DA
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000627:therapeutic use*; D001229:Aspergillosis, Allergic Bronchopulmonary / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D001232:Aspergillus fumigatus; D001987:Bronchiectasis / Q000517:prevention & control; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use; D011379:Prognosis; D014057:Tomography, X-Ray Computed
D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D000935:Antifungal Agents; D001993:Bronchodilator Agents; D005938:Glucocorticoids; D017964:Itraconazole; D011241:Prednisone