Therapy of allergic bronchopulmonary aspergillosis

The management of ABPA depends on the extent and stage of the disease. Underlying asthma should be controlled with environmental changes, pharmaco- and immunotherapy. Baseline examinations and evaluations of pulmonary function, airway and parenchymal anatomy, and serum total IgE levels are important and should be re-evaluated based on the clinical course of the patient. The mainstay of pharmacotherapy for ABPA remains oral corticosteroids. The dose and duration of treatment in the initial stage of the disease depends on when it was diagnosed as well as the patient's clinical course. Anti-fungal agents should be considered as adjunctive. Clinical data suggests that the early institution of treatment is likely to prevent progression of ABPA to end-stage fibrosis.