{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T18:52:17Z","timestamp":1771008737907,"version":"3.50.1"},"reference-count":48,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,7,1]],"date-time":"2020-07-01T00:00:00Z","timestamp":1593561600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Chronic pulmonary aspergillosis (CPA) is a potentially life\u2010threatening debilitating lung disease necessitating long\u2010term oral antifungal treatment. However, development of antifungal\u2010resistant isolates of <jats:italic>Aspergillus<\/jats:italic> and major toxicities requiring discontinuation of treatment limits their use. Intravenous (IV) antifungals are an option in this group of patients. We comprehensively evaluate the response rates to IV antifungals in the management of CPA. We searched Medline and Embase databases to select clinical studies providing information about IV amphotericin B or an echinocandin for the treatment of CPA from inception to May 2020. Reviews, single\u2010case reports and case series reporting &lt;10 patients were excluded. We evaluated 12 eligible studies. A total of 380 patients received amphotericin B (n\u00a0=\u00a0143) or an echinocandin (n\u00a0=\u00a0237) and were included in the meta\u2010analysis. In a pooled analysis, overall response to IV antifungals was 61% ((95% confidence interval (CI): 52%\u201070%; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a073.3%; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001), to amphotericin B was 58% (95% CI: 36%\u201080%; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a086.6%; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) and to echinocandins was 62% (95% CI: 53%\u201072%; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a063.6%; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). Amphotericin B courses were usually doses at slightly &lt;1\u00a0mg\/Kg (deoxycholate) or 3\u00a0mg\/Kg (liposomal) for 2\u20103\u00a0weeks. Micafungin doses varied from 12.5 to 300\u00a0mg (frequently, 150\u00a0mg) daily for at least 3\u00a0weeks, and sometimes much longer. Liposomal amphotericin B was well tolerated, but led to renal function loss in 25% of patients. Adverse events were observed in 5\u201035.3% of patients receiving echinocandins, none of which was considered major. Intravenous antifungals have a place in the management of CPA. A head\u2010to\u2010head comparison of amphotericin B and echinocandins is lacking, and future studies should look at evaluating short\u2010 and longer\u2010term outcomes of these agents.<\/jats:p>","DOI":"10.1111\/myc.13131","type":"journal-article","created":{"date-parts":[[2020,6,16]],"date-time":"2020-06-16T00:10:22Z","timestamp":1592266222000},"page":"921-927","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Intravenous therapy for chronic pulmonary aspergillosis: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4515-8517","authenticated-orcid":false,"given":"Felix","family":"Bongomin","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology &amp; Immunology Faculty of Medicine Gulu University Gulu Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucy Grace","family":"Asio","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology &amp; Immunology Faculty of Medicine Gulu University Gulu Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1289-0111","authenticated-orcid":false,"given":"Ronald","family":"Olum","sequence":"additional","affiliation":[{"name":"School of Medicine College of Health Sciences Makerere University Kampala Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5626-2251","authenticated-orcid":false,"given":"David W.","family":"Denning","sequence":"additional","affiliation":[{"name":"The National Aspergillosis Centre Wythenshawe Hospital Manchester University NHS Foundation Trust Manchester UK"},{"name":"Division of Infection, Immunity and Respiratory Medicine School of Biological Sciences Faculty of Biology, Medicine and Health The University of Manchester Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,7]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1086\/376526"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2018.01.002"},{"key":"e_1_2_10_4_1","first-page":"621","article-title":"Pulmonary aspergilloma: analysis of cavitating invasive pulmonary aspergillosis in immunocompromised patients","volume":"53","author":"Jewkes J","year":"1983","journal-title":"Ann Thorac Surg"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2012.01.014"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0188716"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.52.9142"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01062-2016"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0193732"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00583-2015"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw326"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit411"},{"issue":"5","key":"e_1_2_10_13_1","first-page":"835","article-title":"Selection of oral antifungals for initial maintenance therapy in chronic pulmonary aspergillosis: a longitudinal analysis","volume":"70","author":"Tashiro M","year":"2020","journal-title":"Clin Infect Dis"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/17476348.2020.1750956"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2018.06.001"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/1749-8090-8-180"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2009.01.019"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2010.08.005"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2016.06.001"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2019-213606"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/2046-4053-4-1"},{"issue":"1","key":"e_1_2_10_22_1","first-page":"57","article-title":"Amphotericin B in the treatment of saprophytic forms of pulmonary Aspergillosis","volume":"109","author":"Hammerman KJ","year":"1974","journal-title":"Am Rev Respir Dis"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2016.06.001"},{"issue":"4","key":"e_1_2_10_24_1","first-page":"167","article-title":"Intravenous liposomal amphotericin b versus voriconazole for chronic pulmonary aspergillosis: A multicenter trial in Japan","volume":"61","author":"Kohno S","year":"2018","journal-title":"Acta Med Nagasaki"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.12857"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-012-1754-z"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365540410020406"},{"issue":"7","key":"e_1_2_10_28_1","first-page":"688","article-title":"Clinical efficacy and safety of micafungin in Japanese patients with chronic pulmonary aspergillosis: a prospective observational study","volume":"49","author":"Kohno S","year":"2011","journal-title":"Med Mycol"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10156-012-0391-x"},{"issue":"11","key":"e_1_2_10_30_1","first-page":"985","article-title":"Short\u2010term efficacy evaluation of chronic pulmonary aspergillosis treated with micafangin and maintenance therapy of itraconazole","volume":"47","author":"Yasuda S","year":"2009","journal-title":"Nihon Kokyuki Gakkai Zasshi"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2013-203988"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-012-1754-z"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12281-017-0304-7"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.48.3.693-715.2004"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.2012.06758.x"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.36.4.442"},{"issue":"3","key":"e_1_2_10_37_1","first-page":"205","article-title":"Pilot study of intermittent administration of liposomal amphotericin B for chronic pulmonary aspergillosis","volume":"67","author":"Fujita M","year":"2014","journal-title":"Jpn J Antibiot"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-016-0538-7"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00046-13"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/49.suppl_1.21"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.38.4.713"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01698-15"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1517\/13543784.12.8.1313"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ814"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.2165\/11585270-000000000-00000"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/crj.13171"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2016.02.640"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01277-17"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01165-19"}],"container-title":["Mycoses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fmyc.13131","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/myc.13131","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/myc.13131","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/myc.13131","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T09:24:33Z","timestamp":1693905873000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/myc.13131"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7]]},"references-count":48,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2020,9]]}},"alternative-id":["10.1111\/myc.13131"],"URL":"https:\/\/doi.org\/10.1111\/myc.13131","archive":["Portico"],"relation":{},"ISSN":["0933-7407","1439-0507"],"issn-type":[{"value":"0933-7407","type":"print"},{"value":"1439-0507","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7]]},"assertion":[{"value":"2020-05-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-06-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}