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A prospective study comparing Itraconazole and systemic steroids as an adjunct to topical steroids in the post-operative management of Allergic fungal rhinosinusitis
  • Amala Salil,
  • Nedha Joy,
  • Bini Faizal
Amala Salil
Amrita Institute of Medical Sciences and Research Centre

Corresponding Author:[email protected]

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Nedha Joy
Amrita Institute of Medical Sciences and Research Centre
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Bini Faizal
Amrita Institute of Medical Sciences and Research Centre
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Abstract

Title: A prospective study comparing Itraconazole and systemic steroids as an adjunct to topical steroids in the post-operative management of Allergic fungal rhinosinusitis ABSTRACT Objectives The objective of this study was to compare the efficacy of Itraconazole and systemic steroids as an adjuvant to topical steroids in post-operative patients with Allergic Fungal Rhinosinusitis (AFRS) using both subjective and objective outcome measurements. Methods A prospective comparative study was conducted in a tertiary care center on 60 patients diagnosed with AFRS. Patients with chronic systemic illness and those undergoing revision surgery were excluded. Post-operative patients were divided into two groups of 30 each which received Itraconazole 400 mg OD or Methylprednisolone in tapering doses over six weeks. The outcomes were measured at the end of 6 weeks -Kupferberg endoscopic staging, Absolute Eosinophilic Count (AEC), Serum Immunoglobulin (IgE), and Sino Nasal Outcome Test - 20 scores. Results Our study showed no statistical significance in outcomes between the two groups treated with Itraconazole and Methylprednisolone regarding recurrence, AEC, IgE, and Quality of Life Assessment (p<0.01). Conclusion Itraconazole was comparable to Methylprednisolone in preventing disease recurrence in the post-operative management of AFRS. It may be a viable alternative to replacing systemic steroids where the latter may be contraindicated. Itraconazole given at a dose of 400 mg once daily for six weeks was a safe dose. Keywords: Allergic Fungal Rhinosinusitis, Itraconazole, endoscopy, Quality of Life, Methylprednisolone Key points: • Itraconazole was comparable to systemic steroid (Methylprednisolone) in preventing disease recurrence in the post-operative management of AFRS. • It may be a viable alternative to replacing systemic steroids where the latter may be contraindicated. • Itraconazole given at a dose of 400 mg once daily for six weeks was a safe dose. • Recurrence may be treated safely with Itraconazole than with steroids. • The course may be repeated in case of recurrence with close monitoring.
30 May 2022Submitted to Clinical Otolaryngology
02 Jun 2022Submission Checks Completed
02 Jun 2022Assigned to Editor
04 Jun 2022Reviewer(s) Assigned
23 Jun 2022Review(s) Completed, Editorial Evaluation Pending
03 Jul 2022Editorial Decision: Revise Major
20 Sep 20221st Revision Received
21 Sep 2022Submission Checks Completed
21 Sep 2022Assigned to Editor
21 Sep 2022Reviewer(s) Assigned
16 Oct 2022Review(s) Completed, Editorial Evaluation Pending
16 Oct 2022Editorial Decision: Revise Minor
21 Oct 20222nd Revision Received
26 Oct 2022Submission Checks Completed
26 Oct 2022Assigned to Editor
26 Oct 2022Reviewer(s) Assigned
31 Oct 2022Review(s) Completed, Editorial Evaluation Pending
05 Nov 2022Editorial Decision: Revise Minor
06 Nov 20223rd Revision Received
14 Nov 2022Submission Checks Completed
14 Nov 2022Assigned to Editor
16 Nov 2022Review(s) Completed, Editorial Evaluation Pending
20 Nov 2022Editorial Decision: Accept