Amphotericin B and lysine acetylsalicylate in the combined treatment of nasal polyposis associated with mycotic infection.
BACKGROUND
Fungal infection may be secondary to nasal polyposis or represent a real etiopathogenic factor in the infection itself.


OBJECTIVE
The aim of this study was to evaluate the effectiveness of a combined treatment with lysine acetylsalicylate (LAS) and amphotericin B in preventing recurrence in patients with nasal polyposis with accompanying mycotic infection in comparison with a control group with nasal polyposis and fungal infection who did not receive antifungal therapy.


METHODS
A total of 115 patients with nasal polyposis were randomly assigned to 4 different groups and treated as follows: (1) group A, 25 patients were first surgically treated and then treated with LAS; (2) group B, 25 patients received 40 mg of triamcinolone retard intramuscularly 3 times every 10 days (total dose 120 mg) and then they were treated with LAS; (3) group C, 16 patients were surgically treated and then treated with LAS and amphotericin B; (4) group D: 23 patients were treated with a medical polypectomy and steroids (as in the group B) and then with LAS and amphotericin B.


RESULTS
We found no significant differences between groups C and D, groups C and A, or groups B and D. However, the recurrence of nasal polyps in the groups treated with amphotericin B plus LAS (C and D) was significantly lower (P = .018) than in the 2 groups treated only with LAS (A and B).


CONCLUSIONS
Our results indicate that long term topical treatment with LAS and amphotericin B may be clinically effective in the treatment of patients with nasal polyposis associated with fungal infection.
Corradini
C
C
ENT Department, Catholic University of the Sacred Hearth, Rome, Italy.
Del Ninno
M
M
Buonomo
A
A
Nucera
E
E
Paludetti
G
G
Alonzi
C
C
Sabato
V
V
Schiavino
D
D
Patriarca
G
G
D000281:Administration, Intranasal; D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001241:Aspirin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005658:Fungi / Q000145:classification / Q000302:isolation & purification; D006801:Humans; D053208:Kaplan-Meier Estimate; D008239:Lysine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D009181:Mycoses / Q000150:complications*; D009298:Nasal Polyps / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome
D000935:Antifungal Agents; D000666:Amphotericin B; D008239:Lysine; D001241:Aspirin; C010395:acetylsalicylic acid lysinate