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Invasive pulmonary aspergillosis (IPA) is a major problem among patients with prolonged neutropenia. Because inhalation is the route of infection, inhalation therapy with amphotericin B (AMB) might prevent the disease from developing. Although the deoxycholate formulation of AMB can act as a detergent in the lung, liposomal AMB (LAMB) acts as a surfactant.
To assess whether inhaled LAMB might prevent IPA, researchers in the Netherlands (with industry funding) conducted a randomized trial involving adults with hematologic disease who were expected to have neutropenia for ≥10 days. The 271 participants were randomized to receive LAMB (AmBisome; 12.5 mg) or placebo, delivered using an adaptive aerosolized system, for 30 minutes on 2 consecutive…