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. 2016 Feb 5:15:95-102.
doi: 10.17179/excli2015-678. eCollection 2016.

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

Farshad Hashemian  1 , Farnaz Hashemian  2 , Najmeh Molaali  1 , Mohammadreza Rouini  3 , Elnaz Roohi  1 , Saadat Torabian  4
Affiliations

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

Farshad Hashemian et al. EXCLI J. .

Abstract

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 the present study was to investigate the efficacy of intranasal fluconazole in improving disease symptoms and objective outcomes of patients with CRS. A randomized, double-blind, placebo-controlled study was conducted on 54 patients who were diagnosed with CRS and had not been responsive to routine medical treatments. They were randomly assigned to receive either fluconazole nasal drop 0.2 % or placebo in addition to the standard regimen for 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 was found in SNOT-20 (p = 0.201), endoscopic (p = 0.283), and CT scores (p = 0.212) of the patients at baseline and after 8-week course of treatment between drug and placebo group. Similar to many studies, the use of topical antifungal treatment for patients with CRS was not shown to be significantly effective. However, further studies are needed to obtain high levels of consistent evidence in order to arrive at a decision whether antifungal therapy is effective in management of CRS or not.

Keywords: antifungal therapy; chronic rhinosinusitis; clinical trial; fluconazole.

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Figures

Table 1
Table 1. Demographics of the patients
Table 2
Table 2. Outcome measures before and after the treatment
See this image and copyright information in PMC

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