Aspergillosis is one of the most difficult diseases to treat successfully in avian species. Terbinafine hydrochloride offers numerous potential benefits over traditionally used antifungals for treatment of this disease. Adding nebulized antifungals to treatment strategies is thought to improve clinical outcomes in lung diseases. To determine plasma concentrations of terbinafine after nebulization, 6 adult Hispaniolan Amazon parrots were randomly divided into 2 groups of 3. Each bird was nebulized for 15 minutes with 1 of 2 terbinafine solutions, one made with a crushed tablet and the second with raw drug powder. Blood samples were collected at baseline and at multiple time points up to 720 minutes after completing nebulization. Plasma and nebulization solutions were analyzed by high-performance liquid chromatography. The terbinafine concentration of the solution made with a crushed tablet (0.87 ± 0.05 mg/mL) was significantly lower than was that made with raw powder (1.02 ± 0.09 mg/mL). Plasma concentrations of terbinafine did not differ significantly between birds in the 2 groups. Plasma terbinafine concentrations in birds were maintained above in vitro minimum inhibitory concentrations for approximately 1 hour in birds nebulized with the crushed tablet solution and 4 hours in birds nebulized with the raw powder solution. Higher concentrations of solution, longer nebulization periods, or more frequent administration are likely needed to reach therapeutic plasma concentrations of terbinafine for clinically relevant periods in Hispaniolan Amazon parrots.
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