Is Topical Amphotericin B Efficacious in the Treatment of Chronic Rhinosinusitis?

Background

The etiology of chronic rhinosinusitis (CRS) still remains controversial. Evidence has emerged that a fungal-mediated mechanism may be playing a role in the development of this disease process. In light of this, groups have proposed topical treatment of patients with the antifungal drug amphotericin B. Early studies showed some promise with this treatment, but more recent work has not been as positive. Is there sufficient evidence to continue to recommend this treatment for patients diagnosed with CRS?

Best Practice

The majority of large, recent, randomized, controlled trials have shown that topical amphotericin at a variety of concentrations, delivered via several different delivery routes, has proved ineffective in the treatment of chronic rhinosinusitis. At the evaluated concentrations, there is insufficient evidence to continue to recommend this treatment. Higher concentrations may yet prove to be effective, but further study is required. Read the full article in The Laryngoscope.