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Table 1. Summary of Recommendations for the Treatment
of Aspergillosis (cont'd)
Condition Therapy
Invasive
syndromes of
Aspergillus Primary Alternative Comments
Chronic cavitary
pulmonary
aspergillosis
Similar to IPA Similar to IPA • Innate immune
defects
demonstrated
in most of these
patients.
• Long-term
therapy may be
needed.
• Surgical resection
may lead to
significant
complications.
• Anecdotal
response to IFN-γ.
• Tranexamic acid
may be helpful in
management of
hemoptysis.
Allergic
Syndromes of
Aspergillosis Primary Alternative Comments
ABPA Itraconazole Oral voriconazole
(200 mg PO
every 12 h) or
posaconazole
(dosage depends on
formulation)
Corticosteroids
are a cornerstone
of therapy for
exacerbations;
itraconazole has
a demonstrable
corticosteroid-
sparing effect
Allergic
rhinosinusitis
caused by
Aspergillus
Polypectomy and
sinus washout
with intranasal
corticosteroids
Antifungal
therapy reserved
for refractory or
relapsing cases
