Amphotericin B Irrigation for the Treatment of Chronic Rhinosinusitis without Nasal Polyps: A Randomized, Placebo-controlled, Double-blind Study

Abstract

Our results showed that AMB irrigation improved symptoms and endoscopic scores but did not show superiority to saline irrigation alone in patients who have CRSsNP.

In response to the Effect of Topical Amphotericin B on Inflammatory Markers in Patients with Chronic Rhinosinusitis: A Multicenter Randomized Controlled Study

“…As no differences in appearance, taste, smell, and osmolarity were allowed, a similar diluent was used in our placebo nasal lavage solution. 2 Although Gerlinger et al suggest that current data on topical antifungal effectiveness or ineffectiveness are too heterogeneous to draw any conclusions, we feel that based on data from one uncontrolled prospective trial 4 and four double-blind, placebo controlled studies 2,[5][6][7] (including our double-blind, placebo-controlled study), 2 we are able to conclude that topical antifungals are ineffective in the treatment of CRS patients with and without nasal polyposis. And, although Gerlinger et al suggest that the double-blind, placebo-controlled trial by Ponikau et al is in support of a positive effect of topical amphotericin B in CRS patients, we question whether modest, nonrelevant, radiological improvements without symptomatic benefit are clinically significant.…”

Antifungal Therapy in the Treatment of Chronic Rhinosinusitis: A Meta-Analysis

“…Five trials were pooled for meta-analysis regarding the outcome of disease-specific quality-oflife scores, [35][36][37][38]40 with a total of 143 and 151 patients for the antifungal group and the placebo group, respectively.…”

“…40 Four trials (66.7%) had both adequate sequence generation and allocation concealment as ascertained from the articles or by correspondence. [35][36][37][38] One trial (16.7%) had adequate sequence generation but no information was given regarding the method of allocation concealment and we received no reply from the author. 39 One trial (16.7%) gave no information regarding sequence generation or allocation concealment.…”

“…Four trials (66.7%) had a total score of 5. [35][36][37][38] One (16.7%) trial had a total score of 4 39 and one (16.7%) trial had a total score of 3. 40 Four trials (66.7%) had both adequate sequence generation and allocation concealment as ascertained from the articles or by correspondence.…”

“…Four trials (66.7%) explicitly stated the method of blinding either in the article or by correspondence. [35][36][37][38] All trials addressed dropout and loss to follow-up population. All trials were free of selective reporting.…”