Patients who have received a new organ are usually partially immunocompromised in order to prevent rejection of the organ. This unfortunately leaves them vulnerable to infection with fungal infection being one of the most difficult to treat. Invasive Aspergillosis has a high mortality rate in patients like these and intensive efforts are focussed on improving this situation.
This study uses one of the newest antifungals, voriconazole, and one of the oldest in a new form, inhalable amphotericin. Both are fungicidal and attack different targets so should work together well in combination.
The drugs are used prior to the transplant to attempt to offer prophylactic protection to all patients and are then carried on throughout the transplant process. A total of 53 patients took part.
In the control group 3 patients developed invasive aspergillosis whereas in those patients that reeived voriconazole and inhaled amphotericin there were no cases at all.
There is thus a strong indication that this new combination of drugs offers better protection than the combination of older antifungals used in the control (itraconazole, fluconazole & nystatin).
We cannot say that protection against invasive aspergillosis is complete as this was not a very large trial, but this is certainly another step in learning how best to use the antifungals we have to prevent severe aspergillosis.