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Aerosolized Amphoterticin B to Prevent Aspergillus Lung Infections.

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Aspergillus infections of the lung cause over 200,000 cases of invasive aspergillosis annually worldwide. Immunocompromised patients such as HIV patients, cancer patients, and those on immunesuppressive drugs are at special risk for aspergillosis.  

Di Xia et al. Aerosolized amphotericin B as prophylaxis for invasive pulmonary aspergillosis: a meta-analysis. International Journal of Infectious Disease 2015;30:78-84.

Even with treatment with strong anti-fungal drugs- the hospital fatality rates for invasive Aspergillus infections are often higher than 50%. Aspergillus infections are often difficult to diagnose in patients before serious and life-threatening infections occur. Better means are needed to help prevent Aspergillus infections from occurring in the first place.

Better patient nutrition and better hospital cleanliness can significantly reduce hospital Aspergillus infection rates. Another strategy is to treat immune- suppressed patients with prophylactic drugs like aerosolized amphotericin B in the lungs. Analysis of 6 animal studies reported that treating animals with aerosolized amphotericin reduced fatality rates by 87% (odds ratio= OR of 0.13, 95% confidence interval of 0.08-0.21). Analysis of 2 human studies reported that treating high risk human patients (those with cancer and/or hematological disease and neutropenia [low white blood count]) with aerosolized amphotericin B reduced risk of invasive aspergillosis by 58% (odds ratio= OR of 0.42, 95% confidence interval of 0.22-0.79).



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