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A Meta-Analysis of Topical Nasal Antifungal Agents forChronic Rhinosinusitis |
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| รหัสดีโอไอ | |
| Creator | Thunchai Thanasumpun, Paraya Assanasen |
| Title | A Meta-Analysis of Topical Nasal Antifungal Agents forChronic Rhinosinusitis |
| Publisher | Vajira Medical Journal |
| Publication Year | 2559 |
| Journal Title | Vajira Medical Journal |
| Journal Vol. | 60 |
| Journal No. | 2 |
| Page no. | 89 - 103 |
| Keyword | Topical antifungals, chronic rhinosinusitis, nasal polyps, amphotericin B, fungi |
| ISSN | 0125-1252 |
| Abstract | Objectives: To clarify the possible role of topical antifungal agents in the treatment of chronic rhinosinusitis (CRS) by using available up-to-date data.Methods: We searched the existing evidence in electronic database about the use of topical antifungal agents in the treatment of CRS and its subtypes. We selected only randomized, placebo-controlled trials comparing the use of topical nasal antifungals with placebo, pooled all data and categorized them into different subgroups for meta-analysis. The change of central premise (mean or median) after treatment from individual subgroup was calculated and statistically analyzed.Results: We included 8 published articles combining all data for meta-analysis. The first outcome measured was the mean change of symptom scores after treatment with amphotericin B (AMB) and placebo, no significant differences (p=0.87) in outcome was observed. Comparison between two treatment groups (AMB vs control) did not show any significant differences in endoscopic scores (p=0.08). There were no significant differences in CT scores between AMB and control group (p=0.43). In addition, the subgroup analysis of comparison between two delivery methods (lavage vs spray) showed no significant differences in symptoms, endoscopic scores, and CT scores (P=0.46, p=0.69, p=0.57, respectively). A meta-analysis of post-treatment with complete symptoms data was not different between active and placebo group (standardized mean differences; SMD=0.43, 95%CI -0.48 - 1.34, p=0.35), nasal endoscopic scores data found no different between two patient groups (SMD=0.18, 95%CI - 0.08 - 0.44, p=0.18), and complete CT scores data showed no different in both medication groups (SMD=0.31, 95%CI -0.79 - 1.42, p=0.58)Conclusion: The role of intranasal antifungals agent in the treatment of CRS is still debatable due to the diversion of results in the literatures. This meta-analysis did not show any benefit in regard to symptoms, nasal endoscopic scores or complete CT scores. The future prospective studies are needed to investigate the efficacy of this treatment. |
