ASPERGILLOSIS AND ADVANCES IN ITS TREATMENT IN THE LAST DECADE: A LITERATURE REVIEW

Abstract

Introduction: Invasive aspergillosis (AI) remains a fatal infection and difficult to treat in immunocompromised patients. Standard treatment is insufficient for these patients, often impairing their quality of life due to adverse effects, in addition to the short duration. Although mortality rates in patients with UA have decreased in the past two decades with the replacement of amphotericin B deoxycholate (AmB-D) with voriconazole as the first choice, treatment remains sub-ideal for patients due to adverse events and drug interactions with immunosuppressive drugs. Objective: This study aims to carry out a literary review about the scientific productions that address the treatment of AI published in the last 10 years, comparing the success and effectiveness rates of the treatments. Methodology: Through a literature review using the base dates PubMed, Lilacs and MedLine, accepting only articles published in the period 2010 to 2020, and only those in Portuguese or English, with 23 articles selected, of which 7 were included in this review. Results and discussion: There was a prevalence of treatments with voriconazole, used in six of the seven studies reviewed, in addition to being part of the standard Brazilian treatment. Studies related to the treatment of UA are heterogeneous, making it difficult to compare effectively between publications. Well-designed controlled, randomized and multicenter clinical trials are needed to adequately address the issue of the usefulness of the approaches used in Brazil. In addition, combined therapies come in many different forms, requiring cumulative evidence to support the use of combined antifungal therapy in AI, as they are still conflicting and of moderate strength.