Amphotericin B and lysine acetylsalicylate in the combined treatment of nasal polyposis associated with mycotic infection

J Investig Allergol Clin Immunol. 2006;16(3):188-93.

Abstract

Background: Fungal infection may be secondary to nasal polyposis or represent a real etiopathogenic factor in the infection itself.

Objective: The aim of this study was to evaluate the effectiveness of a combined treatment with lysine acetylsalicylate (LAS) and amphotericin B in preventing recurrence in patients with nasal polyposis with accompanying mycotic infection in comparison with a control group with nasal polyposis and fungal infection who did not receive antifungal therapy.

Patients and methods: A total of 115 patients with nasal polyposis were randomly assigned to 4 different groups and treated as follows: (1) group A, 25 patients were first surgically treated and then treated with LAS; (2) group B, 25 patients received 40 mg of triamcinolone retard intramuscularly 3 times every 10 days (total dose 120 mg) and then they were treated with LAS; (3) group C, 16 patients were surgically treated and then treated with LAS and amphotericin B; (4) group D: 23 patients were treated with a medical polypectomy and steroids (as in the group B) and then with LAS and amphotericin B.

Results: We found no significant differences between groups C and D, groups C and A, or groups B and D. However, the recurrence of nasal polyps in the groups treated with amphotericin B plus LAS (C and D) was significantly lower (P = .018) than in the 2 groups treated only with LAS (A and B).

Conclusion: Our results indicate that long term topical treatment with LAS and amphotericin B may be clinically effective in the treatment of patients with nasal polyposis associated with fungal infection.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Administration, Intranasal
  • Amphotericin B / administration & dosage
  • Amphotericin B / therapeutic use*
  • Antifungal Agents / administration & dosage
  • Antifungal Agents / therapeutic use
  • Aspirin / administration & dosage
  • Aspirin / analogs & derivatives*
  • Aspirin / therapeutic use
  • Dose-Response Relationship, Drug
  • Drug Therapy, Combination
  • Fungi / classification
  • Fungi / isolation & purification
  • Humans
  • Kaplan-Meier Estimate
  • Lysine / administration & dosage
  • Lysine / analogs & derivatives*
  • Lysine / therapeutic use
  • Mycoses / complications*
  • Nasal Polyps / drug therapy*
  • Nasal Polyps / etiology
  • Treatment Outcome

Substances

  • Antifungal Agents
  • Amphotericin B
  • Lysine
  • Aspirin
  • acetylsalicylic acid lysinate