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 co nsists mainly of the reduction of environmental exposure to aspergillu s conidia. More recently, prophylaxis with amphotericin B aerosols has been investigated. Inhalations with amphotericin B aerosols significa ntly delayed mortality in an animal model of invasive pulmonary asperg illosis and high pulmonary concentrations of amphotericin B could be a chieved. 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 ran domized trial has been initiated.