A year-long course of itraconazole is superior to a six-month course at reducing relapses of chronic pulmonary aspergillosis at two years, new research suggests.

Although most guidelines recommend at least six months of antifungal therapy for the condition — typically caused by Aspergillus fumigatus — clinicians say the optimal duration of treatment remains unclear.

To provide clarity on the issue, researchers at the Postgraduate Institute of Medical Education and Research in Chandigarh, India randomly assigned 164 patients (mean age 44) with chronic pulmonary aspergillosis to six or 12 months oral itraconazole 400mg daily.

The median duration of symptoms was six months, with long-standing cough, recurrent haemoptysis and weight loss the most frequently reported symptoms.