Table 3.
Current recommendations of the scientific societies for antifungal therapy against invasive pulmonary Aspergillosis in adults.
| Agent | IDSA Guidelines 2016[31] |
⁎ECIL-6 Guidelines 2017[32] |
⁎ESCMID Guidelines 2018[24] |
⁎SEIMC Guidelines 2019[34] |
Australasian Antifungal Guidelines 2021[33] |
|---|---|---|---|---|---|
| Voriconazole | First line (strong recommendation; high-quality evidence). | First line (AI) | First line (AI) | First line (AI) | First line (Strong recommendation, Level I evidence). |
| Isavuconazole | Alternative therapy (strong recommendation; moderate-quality evidence), | First line (AI) | First line (AI) | First line (AI) | Alternative therapy (Strong recommendation, Level I evidence). |
| Posaconazole | Not mentioned | Not mentioned | Not mentioned | Alternative as salvage therapy when other azoles and liposomal amphotericin B cannot be used (BIII) | Alternative therapy (Strong recommendation, Level I evidence). |
| Liposomal Ampho B | Alternative therapy (strong recommendation; moderate-quality evidence), | First line (BI) | First line (BII) | Alternative or salvage treatment (AII) | Alternative therapy (Moderate recommendation, Level II evidence) |
| AmB lipid complex | Not mentioned | First line (BII) | First line (CIII) | Not mentioned | Not mentioned |
| Echinocandin | Alternative therapy: Caspofungin or Micafungin (weak recommendation; moderate-quality evidence). |
First line Caspofungin (CII) |
First line Caspofungin (CII) Micafungin (CIII) |
Alternative as salvage therapy when other azoles and liposomal amphotericin B cannot be used (BIII) | Second-line or salvage therapy (Marginal recommendation, Level II evidence). |
ECIL: European Conference on Infections in Leukemia; ESCMID: European Society for Clinical Microbiology and Infectious Diseases; IDSA: Infectious Diseases Society of America; SEIMC: Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica.
⁎
Recommendations were graded based on the strength of recommendations (3-level scale: A, B, or C) and quality of evidence (3-level scale: I, II, or III).