title: Clinical effects of topical antifungal therapy in chronic rhinosinusitis: a randomized, double-blind, placebo-controlled trial of intranasal fluconazole.
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.
authors.affiliation: Department of Clinical Pharmacy, Faculty of Pharmacy, Islamic Azad University, Pharmaceutical Sciences Branch, Tehran, Iran.
authors.forename: Farshad
authors.initials: F
authors.lastname: Hashemian
authors.affiliation: Department of Otolaryngology, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Farnaz
authors.initials: F
authors.lastname: Hashemian
authors.affiliation: Department of Clinical Pharmacy, Faculty of Pharmacy, Islamic Azad University, Pharmaceutical Sciences Branch, Tehran, Iran.
authors.forename: Najmeh
authors.initials: N
authors.lastname: Molaali
authors.affiliation: Department of Pharmaceutics, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammadreza
authors.initials: M
authors.lastname: Rouini
authors.affiliation: Department of Clinical Pharmacy, Faculty of Pharmacy, Islamic Azad University, Pharmaceutical Sciences Branch, Tehran, Iran.
authors.forename: Elnaz
authors.initials: E
authors.lastname: Roohi
authors.affiliation: Department of Community Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Saadat
authors.initials: S
authors.lastname: Torabian
keywords: antifungal therapy; chronic rhinosinusitis; clinical trial; fluconazole