Objective To evaluate the efficacy and safety of inhaled amphotericin B ( AmB) in prophylaxis of invasive pulmonary aspergillosis ( IPA) in both animal studies and clinical researches.
Methods MEDLINE, ISI, EMBASE and Wanfang Periodical Databases were searched until march 2011 for case-control study on the efficacy and safety of inhaled AmB in prophylaxis of IPA. The articles were evaluated according to inclusion criteria. Poor-quality studies were excluded, and RevMan 4. 22 sofeware was applied for investigating the heterogeneity among individual studies and calculating the pooled odds ratio ( OR) and 95% confidence interval ( CI) .
Results Five animal studies with a total of 626 animals were included. The overall survival rate of the immunosuppressed animals with pulmonary aspergillosis treated with nebulized AmB was increased ( 38.3% vs. 9.7% , OR=13.93, 95% CI 7.46 ～26.01, P lt;0. 000 01) . Six clinical trials including 1354 patients were considered. Our meta-analysis showed that inhaled AmB could significantly reduce the incidence rate of IPA ( 2.6% vs. 9.2% , OR=0.27, 95% CI 0.16 ～0.46, P lt;0. 000 01) , but had no definite benefit on mortality. Four studies evaluated the potential side effects of nebulized AmB and showed that there were no significant adverse events.
Conclusions Empirical inhaled AmB is associated with a lower rate of IPA but no significant
Citation： LU Xin,SUN Wenkui,GAO Wei,SU Xin,SHI Yi. Efficacy and Safety of Inhaled Amphotericin B in Prophylaxis of Invasive Pulmonary Aspergillosis: A Meta-analysis. Chinese Journal of Respiratory and Critical Care Medicine, 2012, 11(1): 28-36. doi: Copy