infectious diseases
Aspergillosis
Treatment of Aspergillosis
Voriconazole Posaconazole Isavuconazonium Amphotericin B(including lipid formulations) Echinocandins as salvage therapy Sometimes surgery for aspergillomas (See also Antifungal Medications ). ( Treatment references ), Usually, treatment requires reversal of immunosuppression (eg, resolution of neutropenia, discontinuation of corticosteroids). Recrudescence is common if neutropenia recurs. Aspergillomasneither require nor respond to systemic antifungal therapy but may require resection because of local effects, especially hemoptysis. Prophylaxis withposaconazoleoritraconazolecan be considered for high-risk patients (those with graft-vs-host disease or neutropenia due to acute myelocytic leukemia). 1.Herbrecht R, Denning DW, Patterson TF, et al:Voriconazoleversusamphotericin Bfor primary treatment of invasive aspergillosis.N Engl J Med347(6):408–415, 2002. doi: 10.1056/NEJMoa020191 2.Maertens JA, Rahav G, Lee DG, et al:Posaconazoleversusvoriconazolefor primary treatment of invasive aspergillosis: A phase 3, randomised, controlled, non-inferiority trial.Lancet397(10273):499–509, 2021. doi: 10.1016/S0140-6736(21)00219-1.Clarification and additional information.Lancet398(10299):490, 2021. 3.Maertens JA, Raad II, Marr KA, et al:Isavuconazoleversusvoriconazolefor primary treatment of invasive mould disease caused byAspergillusand other filamentous fungi (SECURE): A phase 3, randomised-controlled, non-inferiority trial.Lancet387(10020):760–769, 2016. doi: 10.1016/S0140-6736(15)01159-9 4.Patterson TF, Thompson GR 3rd, Denning DW, et al: Practice guidelines for the diagnosis and management of aspergillosis: 2016 Update by the Infectious Diseases Society of America.Clin Infect Dis63(4):e1–e60, 2016. doi: 10.1093/cid/ciw326 