Inhaled Antifungal Agents for Treatment and Prophylaxis of Bronchopulmonary Invasive Mold Infections

• Published in: Pharmaceutics Vol. 14; no. 3; p. 641
• Main Authors: Brunet, Kévin, Martellosio, Jean-Philippe, Tewes, Frédéric, Marchand, Sandrine, Rammaert, Blandine
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 14-03-2022; MDPI
• Subjects: aerosol; Aerosols; animal model; Antifungal agents; antifungal drugs; antifungal prophylaxis; Disease prevention; Drug dosages; Infections; Inhalers; invasive fungal disease; Life Sciences; Lungs; Mold; Patients; Permeability; Pharmaceutical sciences; Review; Ventilators; invasive fungal disease; antifungal prophylaxis; antifungal drugs; animal model; aerosol
• ISSN: 1999-4923; 1999-4923
• DOI: 10.3390/pharmaceutics14030641

Pulmonary mold infections are life-threatening diseases with high morbi-mortalities. Treatment is based on systemic antifungal agents belonging to the families of polyenes (amphotericin B) and triazoles. Despite this treatment, mortality remains high and the doses of systemic antifungals cannot be increased as they often lead to toxicity. The pulmonary aerosolization of antifungal agents can theoretically increase their concentration at the infectious site, which could improve their efficacy while limiting their systemic exposure and toxicity. However, clinical experience is poor and thus inhaled agent utilization remains unclear in term of indications, drugs, and devices. This comprehensive literature review aims to describe the pharmacokinetic behavior and the efficacy of inhaled antifungal drugs as prophylaxes and curative treatments both in animal models and humans.