BACKGROUND:

Fungal species have been implicated in the pathophysiology of chronic rhinosinusitis (CRS). Based on this observation, some clinicians have employed topical antifungal therapy with amphotericin B (AMB); however, its efficacy has not been consistently supported by the literature.

METHODS:

A comprehensive review of the English-language literature on the role of topical AMB therapy in CRS treatment was performed. Search criteria included placebo-controlled trials between the years of 2000 and 2009. Studies that reported outcomes based on computed tomography (CT), nasal endoscopy (NE), and symptom scores (SS) were included.

RESULTS:

Three published studies reported CT outcomes. After pooling patients from these 3 studies, meta-analysis revealed no significant difference between AMB-treated and control groups (p = 0.07). Four studies reported NE outcomes, in which central tendency (mean or median) and variance were identified. Among these 4 studies, combining AMB-treated patients did not reveal any significant effect when compared to the small control group (p = 0.53). Only 2 studies reported SS; no significant differences in symptoms were noted (p = 0.33).

CONCLUSION:

A systematic review of the literature does not support the use of topical AMB for the treatment of CRS.

Copyright © 2011 American Rhinologic Society-American Academy of Otolaryngic Allergy, LLC.