Topical antifungal treatment of chronic rhinosinusitis with nasal polyps: A randomized, double-blind clinical trial - 25/08/11
![](/templates/common/images/mail.png)
![](/templates/common/images/entites/lowast.gif)
Ulm and Rostock, Germany
Résumé |
Background |
Recently, fungal elements were suspected to be the causative agent of chronic rhinosinusitis, and benefits of topical amphotericin B therapy have been reported.
Objective |
The effects of amphotericin B versus control nasal spray on chronic rhinosinusitis were compared in a double-blind, randomized clinical trial.
Methods |
Patients with chronic rhinosinusitis were administered 200 μL per nostril amphotericin B (3 mg/mL) or saline nasal spray 4 times daily over a period of 8 weeks. The response rate, defined as a 50% reduction of pretreatment computed tomography score, was the primary outcome variable. Additional outcome variables included a symptom score, a quality of life score, and an endoscopy score. Before and after treatment, nasal lavages were pretreated with dithiothreitol and examined for fungal elements by PCR and standard culture techniques.
Results |
Seventy-eight patients were included, and 60 patients finished the study per protocol. In the control group, no positive response (0 of 32) was observed, and 2 of 28 patients responded in the amphotericin B group (P > .2). The symptom scores were distinctly worse after amphotericin B therapy (P < .005). The other parameters investigated did not differ remarkably between the treatment groups.
Conclusion |
Nasal amphotericin B spray in the described dosing and time schedule is ineffective and deteriorates patient symptoms.
Le texte complet de cet article est disponible en PDF.Key words : Nasal polyps, amphotericin B, antifungal agents, sinusitis, fungi
Abbreviations used : AFRS, AMB, CRS, RQL
Plan
Vol 113 - N° 6
P. 1122-1128 - juin 2004 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?