Clinical effects of topical antifungal therapy in chronic rhinosinusitis: a randomized, double-blind, placebo-controlled trial of intranasal fluconazole

摘要

Several studies have been in favor of fungi as a possible pathogenesis of chronic rhinosinusitis (CRS); however,to date, there is no scientific consensus about the use of antifungal agents in disease management. The aim of thepresent study was to investigate the efficacy of intranasal fluconazole in improving disease symptoms and objectiveoutcomes of patients with CRS. A randomized, double-blind, placebo-controlled study was conducted on 54patients who were diagnosed with CRS and had not been responsive to routine medical treatments. They wererandomly assigned to receive either fluconazole nasal drop 0.2 % or placebo in addition to the standard regimenfor a duration of 8 weeks. Patients’ outcomes were evaluated according to Sino-Nasal Outcome Test 20 (SNOT-20), endoscopic scores, and Computed Tomography (CT) scores. No statistically significant difference wasfound in SNOT-20 (p = 0.201), endoscopic (p = 0.283), and CT scores (p = 0.212) of the patients at baseline andafter 8-week course of treatment between drug and placebo group. Similar to many studies, the use of topicalantifungal treatment for patients with CRS was not shown to be significantly effective. However, further studiesare needed to obtain high levels of consistent evidence in order to arrive at a decision whether antifungal therapyis effective in management of CRS or not.