Combined antifungal therapy is superior to monotherapy in pulmonary scedosporiosis in cystic fibrosis

J Cyst Fibros. 2019 Mar;18(2):227-232. doi: 10.1016/j.jcf.2018.08.012. Epub 2018 Oct 6.


Cystic fibrosis (CF) is characterised by chronic airway infection with bacteria and fungi. Infections caused by Scedosporium/Lomentospora species can occur and are difficult to treat. Moulds belonging to the genus Scedosporium/Lomentospora are detected most frequently in respiratory samples of patients with CF, next to Aspergillus spp. Our aim was to define pulmonary fungal infections due to Scedosporium/Lomentospora in CF and to study the antimycotic treatment. In this multicentre study (12 centres; duration January 2008 to December 2014) 31 patients with a lung infection caused by moulds of the genus Scedosporium/Lomentospora were included. 36 courses of antifungal treatment were documented. Scedosporium apiospermum sensu stricto accounted for 48.4% of cases. In 20/31 patients a therapeutic response under antimycotics (median duration 3.9 months) was achieved. Triple and double therapy was significantly more effective compared to monotherapy regarding FEV1, radiology, and symptoms. This data suggests that combined treatment is superior to monotherapy in patients with CF.

Keywords: Anti-fungal treatment; Mycosis; Pneumonia.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Antifungal Agents* / administration & dosage
  • Antifungal Agents* / classification
  • Cystic Fibrosis* / complications
  • Cystic Fibrosis* / microbiology
  • Cystic Fibrosis* / therapy
  • Drug Monitoring / methods
  • Drug Monitoring / statistics & numerical data
  • Drug Therapy, Combination / methods*
  • Female
  • Germany
  • Humans
  • Invasive Fungal Infections* / diagnosis
  • Invasive Fungal Infections* / drug therapy
  • Lung / diagnostic imaging
  • Lung / physiopathology
  • Lung Diseases, Fungal* / diagnosis
  • Lung Diseases, Fungal* / drug therapy
  • Lung Diseases, Fungal* / microbiology
  • Male
  • Outcome and Process Assessment, Health Care
  • Respiratory Function Tests / methods
  • Scedosporium* / drug effects
  • Scedosporium* / isolation & purification
  • Tomography, X-Ray Computed / methods


  • Antifungal Agents

Supplementary concepts

  • scedosporiosis