ReviewFrontiers in medicine2026
Aerosolized antifungal therapy in pulmonary fungal disease: pharmacology, drug delivery and emerging clinical applications.
Review in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Authors and funding
10 authors.
Funding
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Abstract
Pulmonary fungal diseases remain associated with substantial morbidity and mortality, particularly in immunocompromised individuals, transplant recipients, and critically ill patients. Although systemic antifungal therapy remains the cornerstone of treatment, its effectiveness may be limited by suboptimal penetration into selected pulmonary compartments, while systemic toxicity, drug-drug interactions, and prolonged treatment requirements may restrict therapeutic options. Aerosolized antifungal therapy provides a pharmacologically attractive approach to increase local pulmonary drug exposure while limiting systemic exposure. Among currently available formulations, liposomal amphotericin B has the most extensive clinical experience for inhaled administration, supported by favorable pulmonary retention, respiratory tolerability, and compatibility with contemporary nebulization technologies. Advances in vibrating mesh nebulizers and aerosol delivery during invasive mechanical ventilation and high-flow respiratory support have further improved the technical feasibility of targeted pulmonary drug administration. Current clinical evidence is strongest for prophylaxis of invasive pulmonary aspergillosis in selected high-risk populations, particularly patients with prolonged neutropenia. Aerosolized amphotericin B formulations are also incorporated into prophylactic strategies after lung transplantation, although protocols remain heterogeneous and evidence is predominantly observational. By contrast, therapeutic applications beyond prophylaxis remain investigational. The potential role of aerosolized therapy differs substantially among pulmonary fungal diseases according to pathogen biology, anatomical distribution, host characteristics, and accessibility of the affected pulmonary compartment. Chronic pulmonary aspergillosis may provide a rationale for localized drug delivery, but cavitary disease and heterogeneous ventilation may limit aerosol deposition. For pulmonary mucormycosis, cryptococcosis,
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