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Role of nebulized amphotericin B in the management of allergic bronchopulmonary aspergillosis in cystic fibrosis: case report and review of literature.
[allergic bronchopulmonary aspergillosis]
Objectives
:
To
review
the
data
available
in
literature
about
nebulized
amphotericin
B
(
AMB
)
in
the
treatment
of
allergic
bronchopulmonary
aspergillosis
(
ABPA
)
in
cystic
fibrosis
(
CF
)
and
to
report
our
experience
in
the
use
of
this
drug
,
with
a
particular
therapeutic
scheme
.
Case
Report
:
We
used
nebulized
liposomal
amphotericin
B
(
L-
AMB
)
in
a
patient
affected
by
CF
,
complicated
by
ABPA
.
The
previous
combined
treatment
with
oral
steroids
and
azoles
had
no
respiratory
benefit
and
caused
relevant
side
effects
.
Amphotericin
B
has
always
been
well
tolerated
and
permitted
a
slight
steroid
tapering
.
We
also
observed
benefits
in
pulmonary
function
and
laboratory
tests
.
Conclusions
:
Few
data
are
available
in
literature
about
the
use
of
nebulized
AMB
in
CF
and
there
are
no
RCTs
evaluating
antifungals
in
CF
-
ABPA
.
In
our
opinion
,
the
reported
case
suggests
that
nebulized
L-
AMB
could
represent
a
possible
strategy
in
ABPA
management
in
CF
patients
.
