In vitro susceptibility of non-Aspergillus allergenic fungal species to azoles

Sir, Over the last decade, the importance of fungal organisms as allergens has increased. Allergic bronchopulmonary aspergillosis (ABPA) is an inflammatory disease of the airways caused by hypersensitivity to the Aspergillus fumigatus antigen and occurs in 1% of asthmatics and 15% of adult cystic fibrosis patients. The widespread use of itraconazole for the treatment of ABPA has been reported to improve lung function and aid in reducing the concentration of glucocorticosteroids required. 1 Other manifestations of fungal allergy of the respiratory tract include allergic fungal sinusitis and severe asthma with fungal sensitization (SAFS). 2 Recently, a randomized placebo-controlled study of itraconazole treatment of SAFS has shown major improvements in asthmatic control and quality of life in patients sensitized to one of several fungi including Penicillium, Cladosporium and others. 2 These data and the introduction of the new azole drugs voriconazole and posaconazole led us to examine the azole susceptibility of other potentially allergenic moulds. 3 In this study,