Cincinnati Sinus Institute, Group Health Associates, Cincinnati, OH, USA.
Int Forum Allergy Rhinol. 2011 Jul-Aug;1(4):250-4. doi: 10.1002/alr.20056. Epub 2011 May 9.
Fungal species have been implicated in the pathophysiology of chronic rhinosinusitis (CRS). Based on this observation, some clinicians have employed topical antifungal therapy with amphotericin B (AMB); however, its efficacy has not been consistently supported by the literature.
A comprehensive review of the English-language literature on the role of topical AMB therapy in CRS treatment was performed. Search criteria included placebo-controlled trials between the years of 2000 and 2009. Studies that reported outcomes based on computed tomography (CT), nasal endoscopy (NE), and symptom scores (SS) were included.
Three published studies reported CT outcomes. After pooling patients from these 3 studies, meta-analysis revealed no significant difference between AMB-treated and control groups (p = 0.07). Four studies reported NE outcomes, in which central tendency (mean or median) and variance were identified. Among these 4 studies, combining AMB-treated patients did not reveal any significant effect when compared to the small control group (p = 0.53). Only 2 studies reported SS; no significant differences in symptoms were noted (p = 0.33).
A systematic review of the literature does not support the use of topical AMB for the treatment of CRS.
真菌物种已被牵连到慢性鼻-鼻窦炎（CRS）的病理生理学中。基于这一观察结果，一些临床医生已经采用了两性霉素 B（AMB）的局部抗真菌治疗；然而，其疗效并没有得到文献的一致支持。
对 AMB 局部治疗在 CRS 治疗中的作用的英文文献进行了全面回顾。搜索标准包括 2000 年至 2009 年期间的安慰剂对照试验。包括基于计算机断层扫描（CT）、鼻内窥镜（NE）和症状评分（SS）报告结果的研究。
有 3 项已发表的研究报告了 CT 结果。对这 3 项研究中的患者进行汇总后，荟萃分析显示 AMB 治疗组与对照组之间没有显著差异（p = 0.07）。有 4 项研究报告了 NE 结果，其中确定了中心趋势（平均值或中位数）和方差。在这 4 项研究中，与小型对照组相比，联合 AMB 治疗组并没有显示出任何显著的效果（p = 0.53）。只有 2 项研究报告了 SS；症状无显著差异（p = 0.33）。
对文献的系统回顾不支持使用局部 AMB 治疗 CRS。
