Optimization of antimicrobials in the treatment of cystic fibrosis pulmonary exacerbations: II. Therapies for allergic bronchopulmonary aspergillosis

Pediatr Pulmonol. 2020 Dec;55(12):3541-3572. doi: 10.1002/ppul.25080. Epub 2020 Sep 29.

Abstract

This review is the second article in the State-of-the-Art series and aims to evaluate medications used in the treatment of allergic bronchopulmonary aspergillosis (ABPA) in pediatric and adult patients with cystic fibrosis (CF). ABPA is one of several organisms that are found in the airways of CF patients. This review provides an evidence-based summary of pharmacokinetic (PK)/pharmacodynamic (PD), tolerability, and efficacy studies of medications including corticosteroids, amphotericin B, azole antifungals (isavuconazole, itraconazole, posaconazole, and voriconazole), and a monoclonal antibody omalizumab in the treatment of ABPA and identifies areas where further study is warranted.

Keywords: ABPA; anti-fungal therapy; corticosteroids; cystic fibrosis; pharmacology.

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Amphotericin B / therapeutic use
  • Anti-Infective Agents / therapeutic use*
  • Antibodies, Monoclonal / therapeutic use
  • Antifungal Agents / therapeutic use
  • Aspergillosis, Allergic Bronchopulmonary / drug therapy*
  • Child
  • Cystic Fibrosis / complications*
  • Cystic Fibrosis / drug therapy
  • Female
  • Humans
  • Itraconazole / therapeutic use
  • Omalizumab / therapeutic use
  • Voriconazole / therapeutic use

Substances

  • Adrenal Cortex Hormones
  • Anti-Infective Agents
  • Antibodies, Monoclonal
  • Antifungal Agents
  • Omalizumab
  • Itraconazole
  • Amphotericin B
  • Voriconazole