Acute allergic bronchopulmonary aspergillosis (ABPA) requires prompt initiation of evidence-based therapy. Selecting the appropriate first-line agent depends on individual patient factors, most notably whether systemic glucocorticoids are clinically appropriate for that patient.
Initial management centres on an oral agent — either from the corticosteroid class or the antifungal class — chosen according to patient-specific considerations. Where systemic glucocorticoids are contraindicated, the protocol directs a specific alternative. The complete regimen, including which agent to start and how to proceed, is available in the full protocol.
Response is evaluated at 8–12 weeks. A good response is defined by major improvement in symptoms and chest radiographs, together with a clinically meaningful reduction in serum total IgE. Structured monitoring guides ongoing management.