The efficacy of itraconazole, fluticasone and doxycycline in chronic rhinosinusitis.

Background: Different treatment strategies for chronic rhinosinusitis (CRS) have been evaluated. Here we aimed to investigate the effects of fluticasone spray alone and in combination with itraconazole or doxycycline.

Methods: This is an open-label clinical trial performed in 2020-2021 in Isfahan on patients with CRS. This survey's Iranian Registry of Clinical Trials (IRCT) code was IRCT20200825048515N50 (https://en.irct.ir/trial/60826). Demographic data of all patients including age and gender and duration of CRS, were obtained. The SNOT-22 and Lund-Kennedy questionnaires were evaluated and recorded for the symptomatology of CRS. Patients were randomly assigned to the treatment groups to receive 100 mg of doxycycline with intranasal fluticasone spray, intranasal fluticasone spray alone, or itraconazole 100 mg capsules with intranasal fluticasone spray. After one month of treatment, the scores and patient satisfaction were evaluated and compared.

Results: Data of 104 patients was analyzed. Patients had improvements in their symptoms and SNOTT-22 scores. The mean SNOTT-22 score was 55.36±8.36 in all patients. During the study, patients had improvements in their symptoms and SNOTT-22 scores. The mean final SNOTT-22 score was 47.77±7.36 at the end of the survey (P=0.02). Our data also demonstrated significant improvements in the Lund-Kennedy score in all patients during the study (P<0.05).

Conclusion: There were no significant differences between the clinical condition of patients receiving intranasal fluticasone, intranasal fluticasone in combination with doxycycline or itraconazole.