Low-Dose Antifungal Therapy Improves Sputum Rheology and Symptoms in Fungus-Associated Chronic Cough

In a pilot study of 12 patients with chronic productive cough, we retrospectively compared sputum viscoelasticity before macrolide antibiotic administration and the clinical effects of macrolide antibiotic administration between two groups with and without sputum fungal culture. The fungal culture-positive group (n = 6) showed significantly higher sputum rheological parameters in the high-strain region, particularly critical strain (γC), and reduced response to macrolide treatment. In 5 patients with fungus-associated chronic cough, a decrease in high-strain sputum viscoelasticity and improvement in cough and laryngeal abnormal sensations were observed after administration of low-dose antifungals.