The International Society for Human and Animal Mycology (ISHAM) working group proposed recommendations for managing allergic bronchopulmonary aspergillosis (ABPA) a decade ago. There is a need to update these recommendations due to advances in diagnostics and therapeutics.

An international expert group was convened to develop guidelines for managing ABPA (caused by Aspergillus spp.) and allergic bronchopulmonary mycosis (ABPM; caused by fungi other than Aspergillus spp.) in adults and children using a modified Delphi method (two online rounds and one in-person meeting). We defined consensus as ≥70% agreement or disagreement. The terms "recommend" and "suggest" are used when the consensus was ≥70% and <70%, respectively.

We recommend screening for A. fumigatus sensitisation using fungus-specific IgE in all newly diagnosed asthmatic adults at tertiary care but only difficult-to-treat asthmatic children. We recommend diagnosing ABPA in those with predisposing conditions or compatible clinico-radiological presentation, with a mandatory demonstration of fungal sensitisation and serum total IgE ≥500 IU·mL^–1 and two of the following: fungal-specific IgG, peripheral blood eosinophilia or suggestive imaging. ABPM is considered in those with an ABPA-like presentation but normal A. fumigatus-IgE. Additionally, diagnosing ABPM requires repeated growth of the causative fungus from sputum. We do not routinely recommend treating asymptomatic ABPA patients. We recommend oral prednisolone or itraconazole monotherapy for treating acute ABPA (newly diagnosed or exacerbation), with prednisolone and itraconazole combination only for treating recurrent ABPA exacerbations. We have devised an objective multidimensional criterion to assess treatment response.

We have framed consensus guidelines for diagnosing, classifying and treating ABPA/M for patient care and research.

国际人类和动物真菌学协会 (ISHAM) 工作组十年前提出了治疗过敏性支气管肺曲霉病 (ABPA) 的建议。由于诊断和治疗的进步，需要更新这些建议。

召集了一个国际专家组，以制定使用改良德尔菲法（两轮在线轮次和一轮轮次）管理成人和儿童 ABPA（由曲霉属引起）和过敏性支气管肺真菌病（ABPM；由曲霉属以外的真菌引起）的指南。面对面会议）。我们将共识定义为≥70%的同意或不同意。当共识≥70%和<70%时，分别使用术语“推荐”和“建议”。

我们建议使用真菌特异性 IgE 对三级护理中所有新诊断的成人哮喘患者进行烟曲霉致敏筛查，但仅对难以治疗的哮喘儿童进行筛查。我们建议对具有诱发条件或兼容的临床放射学表现的患者诊断 ABPA，并强制证明真菌致敏和血清总 IgE ≥500 IU·mL ^–1以及以下两项：真菌特异性 IgG、外周血嗜酸性粒细胞增多或提示性成像。 ABPM 被认为是那些具有 ABPA 样表现但烟曲霉IgE 正常的患者。此外，诊断 ABPM 需要痰中致病真菌的反复生长。我们通常不建议治疗无症状的 ABPA 患者。我们建议口服泼尼松龙或伊曲康唑单药治疗急性 ABPA（新诊断或恶化），泼尼松龙和伊曲康唑联合疗法仅用于治疗复发性 ABPA 恶化。我们设计了一个客观的多维标准来评估治疗反应。

我们为患者护理和研究制定了诊断、分类和治疗 ABPA/M 的共识指南。