A Cochrane review [Abstract] 1 included 6 RCTs with 380 participants. The patients had chronic rhinosinusitis. Five studies investigated topical and one study systemic antifungals, amphotericin B in five trials and terbinafine in one trial. Pooled meta-analysis showed no statistically significant benefit of topical or systemic antifungals over placebo for any outcome score for symptoms, disease-specific quality of life, nasal endoscopy or radiographic findings and primary patient-reported outcome measure. Symptom scores in fact statistically favoured the placebo group. Adverse event reporting was statistically significantly higher in the antifungal group.
Comment: The quality of the evidence is downgraded by inconsistency (heterogeneity in patients, interventions and outcomes).
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