The treatment of allergic pulmonary aspergillosis

Allergic broncho-pulmonary aspergillosis (ABPA) complicates asthma and mucovicidosis. The factors that support saprophyte growth of Aspergillus fumigatus in the airways are not still perfectly understood. ABPA is frequently accompanied by severe clinical symptoms that are difficult to control with inhaled steroids. While oral steroids remain the treatment of reference, their use nevertheless raises the problem of tolerance during the course of long-term therapy. Antifungal agents represent an attractive therapeutic alternative, but the indications for starting treatment and the criteria for effectiveness, as well as the optimal duration of this treatment, remain to be defined. (C) 2003 Publie par Elsevier SAS.