Antifungal treatment and chronic rhinosinusitis

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Published on: December 20, 2024

Devyani Lal1, James A Stankiewicz

  • 1Department of Otolaryngology-Head and Neck Surgery, Loyola University Medical Center, Building 105, Room 1870, 2160 South 1st Avenue, Maywood, IL 60153, USA.

Current Allergy and Asthma Reports
|April 8, 2009
PubMed

Insights

Antifungal therapy for chronic rhinosinusitis (CRS) is controversial. While some studies suggest benefits, particularly with topical treatments, evidence for its routine use and efficacy, especially oral antifungals, remains limited and debated.

Area of Science:

  • Otolaryngology
  • Immunology
  • Infectious Diseases

Background:

  • Chronic rhinosinusitis (CRS) is a complex inflammatory condition with diverse causes.
  • The role of fungal infections in CRS pathogenesis is increasingly recognized but remains debated.
  • Current treatment guidelines do not routinely include antifungal therapy for CRS.

Purpose of the Study:

  • To review the current evidence regarding the use of antifungal therapy in chronic rhinosinusitis.
  • To evaluate the potential role of fungi in CRS and the efficacy of antifungal treatments.
  • To address the controversy surrounding fungal identification and pathogenicity in CRS.

Main Methods:

  • Review of existing literature on fungal involvement in CRS.
  • Analysis of studies investigating topical and oral antifungal agents for CRS treatment.
  • Examination of immunologic evidence and clinical trial data (or lack thereof).

Main Results:

  • Fungi are implicated in some forms of CRS, but their pathogenic role is debated.
  • Topical antifungal therapy, such as amphotericin B irrigation, shows mixed results in efficacy.
  • Oral antifungal agents like itraconazole are used infrequently, with no clinical trials assessing their efficacy in CRS.

Conclusions:

  • The use of antifungal therapy for CRS is controversial and has limited established indications.
  • Further research is needed to clarify the role of fungi and the efficacy of antifungal treatments in CRS.
  • Current evidence does not support the routine use of antifungals in managing chronic rhinosinusitis.

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