Amphotericin B in the treatment of saprophytic forms of pulmonary aspergillosis

The experience of the Center for Disease Control Cooperative Mycoses Study with the use of amphotericin B in the treatment of saprophytic forms of pulmonary aspergillosis was reviewed. Thirty three patients with aspergillomas were identified, 17 of whom had received amphotericin B intravenously. An additional 38 patients were persistently colonized with an Aspergillus species, but had no discrete fungus ball; 23 of these patients also had received amphotericin B intravenously. Radiographic improvement or clearance of Aspergillus from the sputum occurred no more frequently in the groups that had received amphotericin B than in their untreated counterparts. The data indicated that intravenous administration of amphotericin B is no more effective than a pulmonary toilet regimen in the management of patients with cavitary pulmonary disease who are colonized with Aspergillus.