American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the primary treatment for invasive aspergillosis?

1. Itraconazole

2. Liposomal amphotericin B

3. Voriconazole

4. Amphotericin B deoxycholate

The correct answer is: Voriconazole

The primary treatment for invasive aspergillosis is voriconazole. Voriconazole is known to be more effective than other antifungal agents for this condition, specifically due to its broader spectrum of activity against various species of Aspergillus. Clinical studies have shown that voriconazole has superior outcomes in terms of survival compared to other therapeutic options available for invasive aspergillosis, particularly for strains that are resistant to other antifungals. Voriconazole works by inhibiting the synthesis of ergosterol, a key component of fungal cell membranes, thereby demonstrating potent antifungal activity. Its pharmacokinetic profile, including oral bioavailability, allows for convenient administration in outpatient settings. Additionally, voriconazole is often the first line of treatment due to its efficacy in penetrating tissues effectively, making it suitable for invasive fungal infections. While other options, such as liposomal amphotericin B and itraconazole, have their places in treatment regimens for fungal infections, they do not match the efficacy and specificity of voriconazole when tackling invasive aspergillosis. Amphotericin B deoxycholate, while effective against a variety of fungal infections, is generally not used as the first line for invasive aspergillosis due to its nephro