Skip to main content
SpringerLink
Log in

Aerosolized Antifungals for the Treatment of Pulmonary Fungal Diseases

  • Review
  • Published:
Current Fungal Infection Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Inhaled antifungals achieve high lung concentrations with minimal systemic adverse events. Despite being available for over five decades, data supporting their use outside the mold-active prophylaxis setting are lacking. Herein, we review the recent evidence on inhaled antifungals in treating pulmonary aspergillosis (allergic, chronic, and invasive) and mucormycosis.

Recent Findings

Several antifungals have recently been evaluated, including repurposed and newer inhaled agents (opelconazole). Inhaled amphotericin B deoxycholate (in pulmonary mucormycosis) and liposomal formulation (in invasive aspergillosis) were safely used in two recent randomized trials. However, both these small trials failed to demonstrate added benefit with adjunctive inhaled amphotericin. In allergic bronchopulmonary aspergillosis, nebulized amphotericin B may prolong the time-to-exacerbation when used in patients experiencing frequent exacerbations.

Summary

The last decade has witnessed considerable progress in inhaled antifungals. Ongoing trials will likely offer hope for managing allergic and invasive pulmonary mycoses in the future.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data Availability

No datasets were generated or analysed during the current study.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Agarwal R, Sehgal IS, Dhooria S, Aggarwal AN. Challenging cases in fungal asthma. Med Mycol. 2019;57:S110-s117. https://doi.org/10.1093/mmy/myy063.

    Article  CAS  PubMed  Google Scholar 

  2. Agarwal R, Denning DW, Chakrabarti A. Estimation of the burden of chronic and allergic pulmonary aspergillosis in India. PLoS ONE. 2014;9: e114745. https://doi.org/10.1371/journal.pone.0114745.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Muthu V, Agarwal R, Dhooria S, et al. Has the mortality from pulmonary mucormycosis changed over time? A systematic review and meta-analysis. Clin Microbiol Infect. 2021;27:538–49. https://doi.org/10.1016/j.cmi.2020.12.035.

    Article  PubMed  Google Scholar 

  4. Cornely OA, Böhme A, Buchheidt D, et al. Primary prophylaxis of invasive fungal infections in patients with hematologic malignancies. Recommendations of the Infectious Diseases Working Party of the German Society for Haematology and Oncology. Haematologica. 2009;94:113–22. https://doi.org/10.3324/haematol.11665.

    Article  PubMed  Google Scholar 

  5. Rijnders BJ, Cornelissen JJ, Slobbe L, et al. Aerosolized liposomal amphotericin B for the prevention of invasive pulmonary aspergillosis during prolonged neutropenia: a randomized, placebo-controlled trial. Clin Infect Dis. 2008;46:1401–8. https://doi.org/10.1086/586739.

    Article  CAS  PubMed  Google Scholar 

  6. Groll AH, Lyman CA, Petraitis V, et al. Compartmentalized intrapulmonary pharmacokinetics of amphotericin B and its lipid formulations. Antimicrob Agents Chemother. 2006;50:3418–23. https://doi.org/10.1128/aac.00241-06.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Vogelsinger H, Weiler S, Djanani A, et al. Amphotericin B tissue distribution in autopsy material after treatment with liposomal amphotericin B and amphotericin B colloidal dispersion. J Antimicrob Chemother. 2006;57:1153–60. https://doi.org/10.1093/jac/dkl141.

    Article  CAS  PubMed  Google Scholar 

  8. Hoenigl M, Sprute R, Egger M, et al. The antifungal pipeline: fosmanogepix, ibrexafungerp, olorofim, opelconazole, and rezafungin. Drugs. 2021;81:1703–29. https://doi.org/10.1007/s40265-021-01611-0.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Barzen G, Beyer J, Farshidfar G, Kramp W, Richter W. Felix R [Prophylactic inhalation of amphotericin B in invasive aspergillosis: a distribution study]. Nuklearmedizin. 1993;32:82–6.

    Article  CAS  PubMed  Google Scholar 

  10. Niki Y, Bernard EM, Schmitt HJ, Tong WP, Edwards FF, Armstrong D. Pharmacokinetics of aerosol amphotericin B in rats. Antimicrob Agents Chemother. 1990;34:29–32. https://doi.org/10.1128/aac.34.1.29.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Kilburn KH. The innocuousness and possible therapeutic use of aerosol amphotericin-B. Am Rev Respir Dis. 1959;80:441–2. https://doi.org/10.1164/arrd.1959.80.3.441.

    Article  CAS  PubMed  Google Scholar 

  12. Eisenberg RS, Oatway WH. Nebulization of amphotericin B. Am Rev Respir Dis. 1971;103:289–92. https://doi.org/10.1164/arrd.1971.103.2.289.

    Article  CAS  PubMed  Google Scholar 

  13. Mc KG, Medlock JM. Pulmonary moniliasis treated with nystatin aerosol. Lancet. 1958;1:621–2. https://doi.org/10.1016/s0140-6736(58)90872-9.

    Article  Google Scholar 

  14. Colley T, Alanio A, Kelly SL, et al. In vitro and in vivo antifungal profile of a novel and long-acting inhaled azole, PC945, on Aspergillus fumigatus infection. Antimicrob Agents Chemother. 2017; 61: https://doi.org/10.1128/aac.02280-16.

  15. Kimura G, Nakaoki T, Colley T, et al. In vivo biomarker analysis of the effects of intranasally dosed PC945, a novel antifungal triazole, on Aspergillus fumigatus infection in immunocompromised mice. Antimicrob Agents Chemother. 2017; 61: https://doi.org/10.1128/aac.00124-17.

  16. Ito K. Inhaled antifungal therapy: benefits, challenges, and clinical applications. Expert Opin Drug Deliv. 2022;19:755–69. https://doi.org/10.1080/17425247.2022.2084530.

    Article  CAS  PubMed  Google Scholar 

  17. Huggins JP, Pease R, Stanly K, Workman A, Reynolds J, Alexander BD. Safety of inhaled amphotericin B lipid complex as antifungal prophylaxis in lung transplant recipients. Antimicrob Agents Chemother. 2022;66: e0028322. https://doi.org/10.1128/aac.00283-22. A large study demonstrating the safety of amphotericin B lipid complex in lung transplant recipients.

    Article  CAS  PubMed  Google Scholar 

  18. Mikami M, Nakamura S, Kawakami M. Pulmonary aspergilloma successfully treated with long-term intermittent inhalation therapy with miconazole. Intern Med. 1993;32:247–50. https://doi.org/10.2169/internalmedicine.32.247.

    Article  CAS  PubMed  Google Scholar 

  19. Holle J, Leichsenring M, Meissner PE. Nebulized voriconazole in infections with Scedosporium apiospermum–case report and review of the literature. J Cyst Fibros. 2014;13:400–2. https://doi.org/10.1016/j.jcf.2013.10.014.

    Article  CAS  PubMed  Google Scholar 

  20. Solé A, García-Robles AA, Jordá C, et al. Salvage therapy with topical posaconazole in lung transplant recipients with invasive Scedosporium infection. Am J Transplant. 2018;18:504–9. https://doi.org/10.1111/ajt.14580.

    Article  CAS  PubMed  Google Scholar 

  21. Safdar A, O’Brien S, Kouri IF. Efficacy and feasibility of aerosolized amphotericin B lipid complex therapy in caspofungin breakthrough pulmonary zygomycosis. Bone Marrow Transplant. 2004;34:467–8. https://doi.org/10.1038/sj.bmt.1704552.

    Article  CAS  PubMed  Google Scholar 

  22. Gómez-Ganda L, Terradas-Campanario S, Campany-Herrero D. Physicochemical characterization of micafungin and anidulafungin for its nebulized administration. Farm Hosp. 2019;43:163–5. https://doi.org/10.7399/fh.11226.

    Article  PubMed  Google Scholar 

  23. Los-Arcos I, Berastegui C, Martín-Gómez MT, et al. Nebulized micafungin treatment for scopulariopsis/microascus tracheobronchitis in lung transplant recipients. Antimicrob Agents Chemother. 2021; 65: https://doi.org/10.1128/aac.02174-20.

  24. Yu IG, O’Brien SE, Ryckman DM. Pharmacokinetic and pharmacodynamic comparison of intravenous and inhaled caspofungin. J Aerosol Med Pulm Drug Deliv. 2021;34:197–203. https://doi.org/10.1089/jamp.2020.1645.

    Article  CAS  PubMed  Google Scholar 

  25. Muthu V, Gogineni RR, Agarwal R, et al. Treatment of pulmonary mucormycosis with adjunctive nebulized amphotericin B (MUCONAB trial): results of an open-label randomized controlled trial. Mycoses. 2023;66:688–96. https://doi.org/10.1111/myc.13591. Randomized controlled trial comparing standard of care treatment with or without adjunctive nebulized amphotericin B in pulmonary mucormycosis. First RCT exclusively in pulmonary mucormycosis.

    Article  CAS  PubMed  Google Scholar 

  26. Agarwal R, Singh Sehgal I, Muthu V, et al. Revised ISHAM-ABPA working group clinical practice guidelines for diagnosing, classifying, and treating allergic bronchopulmonary aspergillosis/mycoses. Eur Respir J. 2024; In press: https://doi.org/10.1183/13993003.00061-2024.

  27. Fortun J, Gomez-García-de-la-Pedrosa E, Martínez-Lorca A, et al. A phase I/IIa prospective, randomized, open-label study on the safety and efficacy of nebulized liposomal amphotericin for invasive pulmonary aspergillosis. J Fungi (Basel). 2024;10:191. https://doi.org/10.3390/jof10030191. First randomized trial evaluating aersolized antifungal for invasive pulmonary aspergillosis in hemato-oncology patients.

    Article  PubMed  Google Scholar 

  28. Godet C, Couturaud F, Marchand-Adam S, et al. Nebulised liposomal amphotericin-B as maintenance therapy in allergic bronchopulmonary aspergillosis: a randomised, multicentre trial. Eur Respir J. 2022;59:2102218. https://doi.org/10.1183/13993003.02218-2021. A large single-blind multicenter randomized controlled trial evaluating maintenance therapy with nebulized liposomal amphotericin B in ABPA.

    Article  CAS  PubMed  Google Scholar 

  29. Currie DC, Lueck C, Milburn HJ, et al. Controlled trial of natamycin in the treatment of allergic bronchopulmonary aspergillosis. Thorax. 1990;45:447–50.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. A randomized, double blind, placebo-controlled, prospective, multicentre, phase 2, dose-finding study of itraconazole administered as a dry powder for inhalation (PUR1900) in adult subjects with asthma and allergic bronchopulmonary aspergillosis (ABPA). https://www.ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=NzY5MzY=&Enc=&userName=CTRI/2022/12/048206 Last accessed 5th March 2024.

  31. Hilberg O, Andersen CU, Henning O, Lundby T, Mortensen J, Bendstrup E. Remarkably efficient inhaled antifungal monotherapy for invasive pulmonary aspergillosis. Eur Respir J. 2012;40:271–3. https://doi.org/10.1183/09031936.00163511.

    Article  PubMed  Google Scholar 

  32. Murray A, Cass L, Ito K, et al. PC945, a novel inhaled antifungal agent, for the treatment of respiratory fungal infections. J Fungi (Basel). 2020; 6: https://doi.org/10.3390/jof6040373. Efficacy of a purpose-designed novel triazole (opelconazole) in two post-lung transplant patients with invasive pulmonary aspergillosis.

  33. Singh S, Moore LSP, Mughal N, Ho M, Armstrong-James D, Singh S. Novel inhaled antifungal for pseudomembranous Aspergillus tracheobronchitis complicating connective tissue disease. Thorax. 2023;78:110–1. https://doi.org/10.1136/thorax-2021-218375.

    Article  PubMed  Google Scholar 

  34. Singh D, Ravi A, Kane K, Schmalbach T, Hava DL. The pharmacokinetics, pharmacodynamics and tolerability of PUR0200, a novel tiotropium formulation, in chronic obstructive pulmonary disease. Br J Clin Pharmacol. 2018;84:2097–105. https://doi.org/10.1111/bcp.13645.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Hava DL, Tan L, Johnson P, et al. A phase 1/1b study of PUR1900, an inhaled formulation of itraconazole, in healthy volunteers and asthmatics to study safety, tolerability and pharmacokinetics. Br J Clin Pharmacol. 2020;86:723–33. https://doi.org/10.1111/bcp.14166. Phase 1 study of inhalational itraconazole.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Tolman JA, Nelson NA, Son YJ, et al. Characterization and pharmacokinetic analysis of aerosolized aqueous voriconazole solution. Eur J Pharm Biopharm. 2009;72:199–205. https://doi.org/10.1016/j.ejpb.2008.12.014.

    Article  CAS  PubMed  Google Scholar 

  37. Rudramurthy SM, Colley T, Abdolrasouli A, et al. In vitro antifungal activity of a novel topical triazole PC945 against emerging yeast Candida auris. J Antimicrob Chemother. 2019;74:2943–9. https://doi.org/10.1093/jac/dkz280.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Pagani N, Armstrong-James D, Reed A. Successful salvage therapy for fungal bronchial anastomotic infection after -lung transplantation with an inhaled triazole anti-fungal PC945. J Heart Lung Transplant. 2020;39:1505–6. https://doi.org/10.1016/j.healun.2020.09.015.

    Article  PubMed  Google Scholar 

  39. Cass L, Murray A, Davis A, et al. Safety and nonclinical and clinical pharmacokinetics of PC945, a novel inhaled triazole antifungal agent. Pharmacol Res Perspect. 2021;9: e00690. https://doi.org/10.1002/prp2.690.

    Article  CAS  PubMed  Google Scholar 

  40. Ito K, Kizawa Y, Kimura G, et al. Relationship between anti-fungal effects and lung exposure of PC945, a novel inhaled antifungal agent, in Aspergillus fumigatus infected mice: Pulmonary PK-PD analysis of anti-fungal PC945. Eur J Pharm Sci. 2021;163: 105878. https://doi.org/10.1016/j.ejps.2021.105878.

    Article  CAS  PubMed  Google Scholar 

  41. Labiris NR, Dolovich MB. Pulmonary drug delivery. Part I: physiological factors affecting therapeutic effectiveness of aerosolized medications. Br J Clin Pharmacol. 2003;56:588–99. https://doi.org/10.1046/j.1365-2125.2003.01892.x.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Le J, Schiller DS. Aerosolized delivery of antifungal agents. Curr Fungal Infect Rep. 2010;4:96–102. https://doi.org/10.1007/s12281-010-0011-0.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Le J, Ashley ED, Neuhauser MM, et al. Consensus summary of aerosolized antimicrobial agents: application of guideline criteria Insights from the Society of Infectious Diseases Pharmacists. Pharmacotherapy. 2010;30:562–84. https://doi.org/10.1592/phco.30.6.562.

    Article  CAS  PubMed  Google Scholar 

  44. Otu AA, Langridge P, Denning DW. An evaluation of nebulised amphotericin B deoxycholate (Fungizone(®) ) for treatment of pulmonary aspergillosis in the UK National Aspergillosis Centre. Mycoses. 2019;62:1049–55. https://doi.org/10.1111/myc.12996.

    Article  CAS  PubMed  Google Scholar 

  45. Umemura K, Katada Y, Nakagawa S, et al. Comparison of the safety and cost-effectiveness of nebulized liposomal amphotericin B and amphotericin B deoxycholate for antifungal prophylaxis after lung transplantation. J Infect Chemother. 2024. https://doi.org/10.1016/j.jiac.2024.02.010.

    Article  PubMed  Google Scholar 

  46. Marinelli T, Davoudi S, Foroutan F, Orchanian-Cheff A, Husain S. Antifungal prophylaxis in adult lung transplant recipients: uncertainty despite 30 years of experience A systematic review of the literature and network meta-analysis. Transpl Infect Dis. 2022;24:e13832. https://doi.org/10.1111/tid.13832.

    Article  CAS  PubMed  Google Scholar 

  47. Hagiya H, Nishimura Y, Otsuka F. Safety and usefulness of nebulized liposomal amphotericin B: systematic scoping review. Pulm Pharmacol Ther. 2023;82: 102233. https://doi.org/10.1016/j.pupt.2023.102233.

    Article  CAS  PubMed  Google Scholar 

  48. Muthu V, Agarwal R, Patel A, et al. Definition, diagnosis, and management of COVID-19-associated pulmonary mucormycosis: Delphi consensus statement from the Fungal Infection Study Forum and Academy of Pulmonary Sciences, India. Lancet Infect Dis. 2022;22:e240–53. https://doi.org/10.1016/s1473-3099(22)00124-4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Pulle MV, Puri HV, Asaf BB, Bishnoi S, Sharma S, Kumar A. Outcomes of early anti-fungal therapy with aggressive surgical resection in pulmonary mucormycosis. Lung India. 2021;38:314–20. https://doi.org/10.4103/lungindia.lungindia_758_20.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Patel A, Kaur H, Xess I, et al. A multicentre observational study on the epidemiology, risk factors, management and outcomes of mucormycosis in India. Clin Microbiol Infect. 2020;26(944):e949-944.e915. https://doi.org/10.1016/j.cmi.2019.11.021.

    Article  CAS  Google Scholar 

  51. Ray A, Manikanta J, Singh K, et al. An open-label non-inferiority randomised control trial comparing nebulised amphotericin B with oral itraconazole in patients with pulmonary aspergilloma. Mycoses. 2021;64:1038–44. https://doi.org/10.1111/myc.13329. A small randomized trial comparing nebulized amphotericin B with oral itraconazole in chronic pulmonary aspergillosis.

    Article  CAS  PubMed  Google Scholar 

  52. Ram B, Aggarwal AN, Dhooria S, et al. A pilot randomized trial of nebulized amphotericin in patients with allergic bronchopulmonary aspergillosis. J Asthma. 2016;53:517–24. https://doi.org/10.3109/02770903.2015.1127935.

    Article  CAS  PubMed  Google Scholar 

  53. Damaraju V, Agarwal R, Dhooria S, et al. Isolated tracheobronchial mucormycosis: report of a case and systematic review of literature. Mycoses. 2023;66:5–12. https://doi.org/10.1111/myc.13519.

    Article  PubMed  Google Scholar 

  54. Al Yazidi LS, Huynh J, Britton PN, et al. Endobronchial fusariosis in a child following bilateral lung transplant. Med Mycol Case Rep. 2019;23:77–80. https://doi.org/10.1016/j.mmcr.2019.01.002.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Pruthi H, Muthu V, Bhujade H, et al. Pulmonary artery pseudoaneurysm in COVID-19-associated pulmonary mucormycosis: case series and systematic review of the literature. Mycopathologia. 2022;187:31–7. https://doi.org/10.1007/s11046-021-00610-9.

    Article  CAS  PubMed  Google Scholar 

  56. Sehgal IS, Dhooria S, Muthu V, et al. Efficacy of 12-months oral itraconazole versus 6-months oral itraconazole to prevent relapses of chronic pulmonary aspergillosis: an open-label, randomised controlled trial in India. Lancet Infect Dis. 2022;22:1052–61. https://doi.org/10.1016/s1473-3099(22)00057-3.

    Article  CAS  PubMed  Google Scholar 

  57. Sehgal IS, Dhooria S, Prasad KT, et al. Anti-fungal agents in the treatment of chronic pulmonary aspergillosis: systematic review and a network meta-analysis. Mycoses. 2021;64:1053–61. https://doi.org/10.1111/myc.13324.

    Article  CAS  PubMed  Google Scholar 

  58. Maeda T. A case of chronic necrotizing pulmonary aspergillosis effectively treated with miconazole inhalation. Nihon Kyobu Shikkan Gakkai Zasshi. 1994;32:168–73.

    CAS  PubMed  Google Scholar 

  59. Sato A, Nakatani K, Matsushita Y, et al. Chronic necrotizing pulmonary aspergillosis treated with itraconazole and inhaled amphotericin B. Nihon Kyobu Shikkan Gakkai Zasshi. 1995;33:1141–5.

    CAS  PubMed  Google Scholar 

  60. Diot P, Rivoire B, Le Pape A, et al. Deposition of amphotericin B aerosols in pulmonary aspergilloma. Eur Respir J. 1995;8:1263–8. https://doi.org/10.1183/09031936.95.08081263.

    Article  CAS  PubMed  Google Scholar 

  61. Agarwal R, Muthu V, Sehgal IS, Dhooria S, Prasad KT, Aggarwal AN. Allergic bronchopulmonary aspergillosis. Clin Chest Med. 2022;43:99–125. https://doi.org/10.1016/j.ccm.2021.12.002.

    Article  PubMed  Google Scholar 

  62. Agarwal R, Aggarwal AN, Dhooria S, et al. A randomised trial of glucocorticoids in acute-stage allergic bronchopulmonary aspergillosis complicating asthma. Eur Respir J. 2016;47:490–8. https://doi.org/10.1183/13993003.01475-2015. Randomized trial evaluating the efficacy and safety of two glucocorticoid protocols in ABPA.

    Article  CAS  PubMed  Google Scholar 

  63. Agarwal R, Dhooria S, Singh Sehgal I, et al. A randomized trial of itraconazole vs prednisolone in acute-stage allergic bronchopulmonary aspergillosis complicating asthma. Chest. 2018;153:656–64. https://doi.org/10.1016/j.chest.2018.01.005. First RCT comparing itraconazole monotherapy and prednisolone in ABPA.

    Article  PubMed  Google Scholar 

  64. Henderson AH, Pearson JE. Treatment of bronchopulmonary aspergillosis with observations on the use of natamycin. Thorax. 1968;23:519–23. https://doi.org/10.1136/thx.23.5.519.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  65. Slavin RG, Stanczyk DJ, Lonigro AJ, Broun GO. Allergic bronchopulmonary aspergillosis–a North American Rarity. Clinical and immunologic characteristics. Am J Med. 1969;47:306–13. https://doi.org/10.1016/0002-9343(69)90156-9.

    Article  CAS  PubMed  Google Scholar 

  66. Sehgal IS, Agarwal R. Role of inhaled amphotericin in allergic bronchopulmonary aspergillosis. J Postgrad Med. 2014;60:41–5. https://doi.org/10.4103/0022-3859.128806.

    Article  CAS  PubMed  Google Scholar 

  67. Chishimba L, Langridge P, Powell G, Niven RM, Denning DW. Efficacy and safety of nebulised amphotericin B (NAB) in severe asthma with fungal sensitisation (SAFS) and allergic bronchopulmonary aspergillosis (ABPA). J Asthma. 2015;52:289–95. https://doi.org/10.3109/02770903.2014.958853.

    Article  CAS  PubMed  Google Scholar 

  68. Godet C, Goudet V, Laurent F, et al. Nebulised liposomal amphotericin B for Aspergillus lung diseases: case series and literature review. Mycoses. 2015;58:173–80. https://doi.org/10.1111/myc.12294.

    Article  PubMed  Google Scholar 

  69. Muthu V, Dhooria S, Sehgal IS, et al. Nebulized amphotericin B for preventing exacerbations in allergic bronchopulmonary aspergillosis: a systematic review and meta-analysis. Pulm Pharmacol Ther. 2023;81: 102226. https://doi.org/10.1016/j.pupt.2023.102226.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pulmonary Medicine, Fourth Floor, Nehru Hospital, Postgraduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, 160012, India

    Valliappan Muthu, Inderpaul Singh Sehgal & Ritesh Agarwal

Authors
  1. Valliappan Muthu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Inderpaul Singh Sehgal
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ritesh Agarwal
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

V.M, R.A, and I.S.S, wrote the main manuscript text. V.M prepared the figures and tables. All authors reviewed the manuscript.

Corresponding author

Correspondence to Valliappan Muthu.

Ethics declarations

Conflict of Interest

The authors VM and ISS declare that they have no conflicts of interest. Author RA has received grants from Cipla, India Ltd., to conduct trials in ABPA, including inhaled antifungals in ABPA.

Human and Animal Rights and Informed Consent

This article does not contain any studies of human or animal subjects performed by any of the authors.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Muthu, V., Sehgal, I.S. & Agarwal, R. Aerosolized Antifungals for the Treatment of Pulmonary Fungal Diseases. Curr Fungal Infect Rep (2024). https://doi.org/10.1007/s12281-024-00495-3

Download citation

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s12281-024-00495-3

Keywords

Search

Navigation