Amphotericin has been used as a treatment for aspergillus infections for many years. It is one of the oldest drugs still in use for this purpose and many alternative antifungals have now been developed that are less toxic. Amphotericin is still very useful in some circumstances and is one of the cheaper drugs useful against aspergillus.
Changing the subject slightly - one of the main suspects why treatment for aspergillus infections of the lungs fail is that the fungus grows in the airspaces of the lungs. Oral and injected antifungals travel through the body via the blood supply - there is very little blood supply to the air spaces of the lungs so antifungals do not get to the fungus.
In addition treatment using oral or injected drugs leads to the drug being dispersed around nearly all of the body. Some parts of the body can be more sensitive to the drug than others so it is only possible to give as much drug that will not damage the most sensitive parts of the body. This can severely limit effectiveness of the treatment.
Much better results might be obtained for a fungal infection of the lungs if the antifungal drug could be applied via the air breathed in - that way the drug could attack all of the fungus in the air spaces AND would only be applied in the limited area of the body it was needed i.e. the lungs. Much less drug would be needed and much more fungus would be attacked - in theory.
This paper is a first successful step in the use of aerosolised amphotericin applied via an inhaler. Patients vulnerable to infection (in this case they had no immune system for a few days - referred to as neutropaenia) where given this medication and far fewer became infected with aspergillus compared with the placebo control.
This is not a new treatment as it has been in use in principle for 5 years or so (e.g. to treat vulnerable CF patients) but this is quite a large study so the result is more convincing than most.
Now let's see if it works on patients already chronically infected - particularly ABPA and aspergilloma patients perhaps?