1. Summary of study characteristics.
| Ref ID | Population | Intervention | Adjuvant treatment | ||||
| Inclusion (n) | Polyps | AFRS | Intervention | Method of delivery | Treatment duration | ||
|
Corradini 2006 (Italy) |
Nasal polyps + positive fungal infection (48) |
100% | 0% | Amphotericin B (3 mg/mL) | Inhalation: 0.24 mL/day 6 times per week for 1 month (daily total = 0.8 mg AMB) 0.16 mL/day 6 times per week for undefined time (total daily dose = 0.5 mg AMB) |
Undefined ‐ 19 months? | Medical polypectomy and lysine acetylsalicylate (NSAID) 4 mg/day |
|
Ebbens 2006 (Belgium, UK, Spain, Netherlands) |
Chronic rhinosinusitis ± nasal polyps (116) |
82%% | 0% | Amphotericin B (0.1 mg/mL) |
Irrigation: 25 mL solution applied to each nostril twice daily using an Emcur (Rhinicur) nasal douching device (total daily dose = 10 mg AMB) | 13 weeks | Antibiotics, INCS and systemic steroids were allowed, with restrictions. 68% of participants used INCS. |
|
Hashemian 2016 (Iran) |
Chronic rhinosinusitis ± nasal polyps unresponsive to treatment (54) |
44% | NR | Fluconazole (2 mg/mL (0.2%)) |
Nasal drops: 2 mg/mL (6 drops per day, 2 times a day) (total daily dose = 1.2 mg fluconazole) | 8 weeks | All patients used INCS (fluticasone) |
|
Liang 2008 (Taiwan) |
Chronic rhinosinusitis without nasal polyps (70) | 0% | NR | Amphotericin B (0.04 mg/mL) |
Irrigation: 250 mL (0.04 mg/mL solution) in each nostril once daily using a Sanvic SH903 pulsatile irrigator (total daily dose = 20 mg AMB) | 4 weeks | No adjunct treatment was allowed |
|
Ponikau 2005 (USA) |
Chronic rhinosinusitis unresponsive to treatment (30) 100% with positive fungal culture |
NR | NR | Amphotericin B (0.25 mg/mL) |
Irrigation: 20 mL (0.25 mg/mL solution) in each nostril twice daily using a bulb syringe (total daily dose = 20 mg AMB) | 6 months | Participants continued with current treatment regimen (50% used INCS) |
|
Shin 2004 (South Korea) |
Chronic rhinosinusitis patients with nasal polyps (41) |
100% | 0% | Amphotericin B (high: 0.1 mg/mL; low: 0.05 mg/mL) |
Irrigation: 10 mL of the solution into each nostril twice daily with a syringe High‐dose: 0.1 mg/mL (total daily dose = 4 mg AMB) Low‐dose 0.05 mg/mL (total daily total = 2 mg AMB) |
4 weeks | Not reported |
|
Weschta 2004 (Germany) |
Chronic rhinosinusitis with nasal polyps referred for surgery (78) |
100% | 0% | Amphotericin B (3 mg/mL) |
Nasal spray: 2 puffs per nostril (0.2 mL per nostril), 4 times daily (total daily dose = 4.8 mg) | 8 weeks | Participants continued with current treatment regimen (40% used INCS) |
| Systemic antifungals | |||||||
|
Kennedy 2005 (USA) |
Chronic rhinosinusitis unresponsive to treatment (53) 77% with positive fungal culture |
NR | NR | Terbinafine | Oral: 625 mg/day | 6 weeks | Participants continued with current treatment regimen ‐ regimen was kept consistent |
AFRS: allergic fungal rhinosinusitis; AMB: amphotericin B; INCS: intranasal corticosteroids; NR: not reported
None of the studies reported eosinophilic chronic rhinosinusitis status.