Effect of Amphotericin B on Treatment of Chronic Rhinosinusitis; A Double-blind Randomized Clinical Trial

Abstract

Background: Chronic rhinosinusitis (CRS) is the inflammation of paranasal sinus mucous membranes. Considering the influence of fungi on chronic rhinosinusitis and different results concerning the effect of Amphotericin B on improvement of this condition; this study aimed to determine the effect of topical Amphotericin B on improvement of the symptoms in patients with CRS. Methods: In this double-blind randomized clinical trial, 80 patients with chronic rhinosinusitis who visited the allergy clinic of Baqiyatallah Hospital from June to October 2014 were randomly allocated to two groups; the first group received 10 cc topical lavage of Amphotericin B (5 cc each nostril for every 12 hours) and the second group received placebo for three months. Symptoms, nasal mucusa smear, serum level of inflammatory cytokines, CT scan and rhinoscopy score changes were evaluated in both groups after three months. Results: Fifty-five male and 25 female patients were evaluated in two groups. The mean age was 26.1 ± 2.36 and 27.9 ± 1.59 years in intervention and control groups respectively (P = 0.08). There were no significant differences in demographic data between the groups (P > 0.05). Nasal obstruction, post nasal drip (PND), reduced sense of smell, quality of life, CT scan and rhinoscopy scores were not significantly different between the two groups after intervention (P > 0.05). Facial pain severity score was significantly more reduced in intervention group in comparison with control group (P < 0.01). Conclusions: We concluded that application of Amphotericin B as an adjunctive medication to other common treatments, does not seem to be an efficient method for improvement of CRS symptoms.