title: Aerosolized amphotericin B as prophylaxis for invasive pulmonary aspergillosis: a meta-analysis.
abstract: OBJECTIVE
  Invasive pulmonary aspergillosis (IPA) is associated with high mortality in high-risk (immunosuppressed) patients. Many studies have investigated whether prophylactic inhalation of amphotericin B (AMB) reduces the incidence of IPA, but no definitive conclusions have been reached. The present meta-analysis was performed to evaluate the efficacy of prophylactic inhalation of AMB for the prevention of IPA.
  
  
  METHODS
  MEDLINE and other databases were searched for relevant articles published until December 2013. Randomized controlled trials that compared aerosolized AMB with placebo were included. Two reviewers independently assessed and extracted the data of all trials.
  
  
  RESULTS
  Six animal studies and two clinical trials involving 768 high-risk patients were eligible. The animal studies showed lower overall mortality rate among animals that underwent aerosolized AMB prophylaxis (odds ratio (OR) 0.13, 95% confidence interval (CI) 0.08-0.21). Similarly, the clinical trials showed a lower incidence of IPA among patients who underwent aerosolized AMB prophylaxis (OR 0.42, 95% CI 0.22-0.79).
  
  
  CONCLUSIONS
  This analysis provides evidence supporting the notion that the prophylactic use of aerosolized AMB effectively reduces the incidence of IPA among high-risk patients.
authors.affiliation: Department of Respiratory and Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, People's Republic of China.
authors.forename: Di
authors.initials: D
authors.lastname: Xia
authors.affiliation: Department of Respiratory and Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, People's Republic of China.
authors.forename: Wen-Kui
authors.initials: WK
authors.lastname: Sun
authors.affiliation: Department of Respiratory and Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, People's Republic of China.
authors.forename: Ming-Ming
authors.initials: MM
authors.lastname: Tan
authors.affiliation: Department of Respiratory and Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, People's Republic of China.
authors.forename: Ming
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Department of Respiratory and Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, People's Republic of China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Ding
authors.affiliation: Southern Medical University, Guangdong, People's Republic of China.
authors.forename: Zhi-Cheng
authors.initials: ZC
authors.lastname: Liu
authors.affiliation: Department of Respiratory and Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, People's Republic of China. Electronic address: suxinjs@163.com.
authors.forename: Xin
authors.initials: X
authors.lastname: Su
authors.affiliation: Department of Respiratory and Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, People's Republic of China. Electronic address: shiyi56@126.com.
authors.forename: Yi
authors.initials: Y
authors.lastname: Shi
mesh_terms: D000280:Administration, Inhalation; D000336:Aerosols; D000666:Amphotericin B / Q000008:administration & dosage* / Q000627:therapeutic use; D000818:Animals; D000935:Antifungal Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D006168:Guinea Pigs; D006801:Humans; D015994:Incidence; D055744:Invasive Pulmonary Aspergillosis / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control*; D051379:Mice; D051381:Rats
chemical_list: D000336:Aerosols; D000935:Antifungal Agents; D000666:Amphotericin B
keywords: Aerosolized amphotericin B; Immunosuppression; Invasive pulmonary aspergillosis; Meta-analysis; Prophylaxis