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rhinosinusitis antibiotics

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https://www.readbyqxmd.com/read/28166559/should-we-prescribe-antibiotics-to-this-patient-with-persistent-upper-respiratory-symptoms-grand-rounds-discussion-from-beth-israel-deaconess-medical-center
#1
Howard Libman, Diane M Brockmeyer, Howard S Gold
The American College of Physicians (ACP) and the Centers for Disease Control and Prevention (CDC) recently published advice for high-value care on the appropriate use of antibiotics for acute respiratory tract infections. They conducted a narrative literature review of evidence for antibiotic use in this setting that included recent clinical guidelines from professional societies supplemented by randomized, controlled trials; meta-analyses; and systematic reviews. They concluded that clinicians should reserve antibiotic treatment for acute rhinosinusitis in patients with persistent symptoms for more than 10 days, high fever and purulent nasal discharge or facial pain lasting for at least 3 consecutive days, or worsening symptoms after a typical viral illness that lasted 5 days and had initially improved ("double-sickening")...
February 7, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28132798/the-clinical-significance-of-specific-antibody-deficiency-sad-severity-in-chronic-rhinosinusitis-crs
#2
Anjeni Keswani, Neha M Dunn, Angelica Manzur, Sara Kashani, Xavier Bossuyt, Leslie C Grammer, David B Conley, Bruce K Tan, Robert C Kern, Robert P Schleimer, Anju T Peters
BACKGROUND: Despite the increased identification of specific antibody deficiency (SAD) in chronic rhinosinusitis (CRS), little is known about the relationship between SAD severity and the severity and comorbidities of CRS. The prevalence of an impaired antibody response in the general population is also unknown. OBJECTIVE: The objective of this study was to determine if the SAD severity stratification applies to real-life data of patients with CRS. METHODS: An electronic health record database was used to identify patients with CRS evaluated for humoral immunodeficiency with quantitative immunoglobulins and Streptococcus pneumoniae antibody titers before and after pneumococcal vaccine...
January 26, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28126352/preclinical-evaluation-of-luffa-operculata-cogn-and-its-main-active-principle-in-the-treatment-of-bacterial-rhinosinusitis
#3
Leonardo Silva, Henrique Olival Costa, Flávia Coelho de Souza, Elaine Monteiro Cardoso Lopes, Suely Mitoi Ykko Ueda
INTRODUCTION: The prevalence of rhinosinusitis is quite high. Despite the widespread use of antibiotics for rhinosinusitis, there are other forms of treatment, including phytotherapy. One of the most widely used herbal medicines for treatment of rhinosinusitis is Luffa operculata. OBJECTIVE: This study aimed to evaluate the efficacy of topical nasal solution of the aqueous extract of L. operculata, determining the toxicity to its use and identifying the active principles presented in the aqueous extract...
December 26, 2016: Brazilian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/28124653/practice-patterns-in-pediatric-chronic-rhinosinusitis-a-survey-of-the-american-rhinologic-society
#4
Daniel M Beswick, Hassan Ramadan, Fuad M Baroody, Peter H Hwang
BACKGROUND: The management of pediatric chronic rhinosinusitis (PCRS) is evolving. OBJECTIVE: To assess current practice patterns of members of the American Rhinologic Society (ARS) in managing PCRS. METHODS: A 27-item Web-based survey on treatment of PCRS was electronically distributed to the ARS membership. RESULTS: The survey was completed by 67 members, 40% of whom had completed a rhinology fellowship. The most frequently used medical therapies as part of initial treatment for PCRS were nasal saline solution irrigation, (90%), topical nasal steroids (93%), oral antibiotics (52%), and oral steroids (20%)...
November 1, 2016: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/28124652/culture-directed-topical-antibiotic-treatment-for-chronic-rhinosinusitis
#5
Victoria S Lee, Greg E Davis
BACKGROUND: Topical antibiotics, delivered optimally as high-volume culture-directed sinus irrigations, are being increasingly used for recalcitrant chronic rhinosinusitis (CRS). Their impact on subjective and objective outcome measures, however, is still unclear. OBJECTIVE: To assess if the use of topical antibiotics in recalcitrant CRS is associated with improved 20-Item Sino-Nasal Outcome Test and Lund-Kennedy endoscopic scores, and to determine the negative posttreatment culture "control" rate...
November 1, 2016: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/28123509/different-roles-of-staphylococcus-aureus-enterotoxin-in-different-subtypes-of-nasal-polyps
#6
Ke-Jia Cheng, Shen-Qing Wang, Ying-Ying Xu
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a multifactorial disease. The pathogenesis of CRSwNP remains unclear. This study was designed to investigate the role of inflammation and Staphylococcus aureus enterotoxin (SE) in this disease. The study included a total of 74 patients with CRSwNP and 6 controls. A serum Phadiatop assay was conducted to detect atopy status, and serum eosinophil cationic protein (ECP) and total immunoglobulin (Ig)E levels were determined using ELISA. SEA, SEB, total IgE, ECP and myeloperoxidase (MPO) levels in nasal tissue supernatant were measured using ELISA...
January 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28059446/elimination-of-pain-improves-specificity-of-clinical-diagnostic-criteria-for-adult-chronic-rhinosinusitis
#7
Scott D Hirsch, Evan R Reiter, Laurence J DiNardo, Wen Wan, Theodore A Schuman
OBJECTIVE: Determine whether the elimination of pain improves accuracy of clinical diagnostic criteria for adult chronic rhinosinusitis. STUDY DESIGN: Retrospective cohort study. METHODS: History, symptoms, nasal endoscopy, and computed tomography (CT) results were analyzed for 1,186 adults referred to an academic otolaryngology clinic with presumptive diagnosis of chronic rhinosinusitis. Clinical diagnosis was rendered using the 1997 Rhinosinusitis Taskforce (RSTF) Guidelines and a modified version eliminating facial pain, ear pain, dental pain, and headache...
January 6, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28042687/unsupervised-network-mapping-of-commercially-available-immunoassay-yields-three-distinct-chronic-rhinosinusitis-endotypes
#8
Rohit Divekar, Matthew Rank, Diane Squillace, Hirohito Kita, Devyani Lal
BACKGROUND: Endotyping chronic rhinosinusitis (CRS) through simplified cytokine assays may help direct individualized therapy such as corticosteroids, antibiotics, or biologics. We performed an unsupervised network analysis to endotype CRS and control subjects using a commercially available cytokine-chemokine immunoassay. METHODS: A 41-plex cytokine-chemokine array along with major basic protein (MBP) assay was performed on sinonasal surgical tissue of 32 adults...
January 2, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28042527/pediatric-rhinosinusitis
#9
Dana T Badr, Jonathan M Gaffin, Wanda Phipatanakul
Rhinosinusitis, is defined as an inflammation of the paranasal and nasal sinus mucosae. Chronic rhinosinusitis (CRS)is a common problem in the pediatric age group and the diagnosis and treatment are challenging due to the chronicity and similarity of symptoms with allergic rhinitis and adenoid hypertrophy. Although it is less common than acute rhinosinusitis, CRS is becoming more frequent and significantly affects the quality of life in children and can substantially impair daily function. CRS is characterized by sinus symptoms lasting more than 3 months despite medical therapy...
September 2016: Current Treatment Options in Allergy
https://www.readbyqxmd.com/read/27992118/tolerance-and-pharmacokinetics-of-a-ciprofloxacin-coated-sinus-stent-in-a-preclinical-model
#10
Do-Yeon Cho, Kyle Hoffman, Daniel Skinner, Calvin Mackey, Dong Jin Lim, Grant C Alexander, Chae Yun Bae, Dong Keun Han, Ho-Wook Jun, Bradford A Woodworth
BACKGROUND: Chronic rhinosinusitis (CRS) is often associated with persistent bacterial infection despite the use of systemic antibiotics. Topically administered antibiotics are an alternative strategy, but require effective local concentrations, prolonged mucosal contact time, minor systemic absorption, and minimal depletion. The objectives of the current study were to analyze the in vitro release rate and in vivo drug delivery tolerance and pharmacokinetics of a ciprofloxacin-coated sinus stent (CSS)...
December 19, 2016: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/27958666/sinusitis-in-patients-on-tumor-necrosis-factor-alpha-inhibitors
#11
Cynthia S Wang, Adam Honeybrook, Nikita Chapurin, Anjeni Keswani, David W Jang
BACKGROUND: Tumor necrosis factor alpha (TNF-α) inhibitors have revolutionized treatment of many inflammatory diseases. Sinusitis after initiation of TNF-α inhibitors has been observed, but has not been well described in the literature. We aim to characterize the clinical features of sinusitis in patients on anti-TNF-α therapy. METHODS: This is a retrospective chart review of 28 patients on a TNF-α inhibitor diagnosed with sinusitis by otolaryngologists at Duke University...
December 13, 2016: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/27935259/manuka-honey-sinus-irrigation-for-the-treatment-of-chronic-rhinosinusitis-a-randomized-controlled-trial
#12
Victoria S Lee, Ian M Humphreys, Patricia L Purcell, Greg E Davis
BACKGROUND: Manuka honey (MH) has been shown in vitro to be effective against biofilm-producing bacteria. This study assessed the effectiveness of MH for patients with active chronic rhinosinusitis (CRS) and prior sinus surgery. METHODS: This prospective single-blinded (clinician only) randomized controlled trial recruited patients with active CRS and prior sinus surgery. Patients received either MH or saline (SAL) sinus irrigations twice daily for 30 days and were offered oral antibiotics and/or oral/topical steroids as indicated...
December 9, 2016: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/27907108/mupirocin-in-the-treatment-of-staphylococcal-infections-in-chronic-rhinosinusitis-a-meta-analysis
#13
Jong Seung Kim, Sam Hyun Kwon
BACKGROUND: Saline irrigation of the nasal cavity is a classic and effective treatment for acute or chronic rhinosinusitis. Topical antibiotics such as mupirocin have been widely used for recalcitrant chronic rhinosinusitis. Therefore, the purpose of this study was to evaluate the effect of saline irrigation using mupirocin. METHODS: A systematic literature review and meta-analysis of mupirocin saline irrigation were performed using EMBASE, MEDLINE, and Cochrane library through December 2015...
2016: PloS One
https://www.readbyqxmd.com/read/27906696/medical-therapy-refractory-chronic-rhinosinusitis-and-productivity-costs
#14
Kristine A Smith, Luke Rudmik
PURPOSE OF REVIEW: The purpose of this review is to address the most recent advances in the medical therapy for chronic rhinosinusitis (CRS), define recalcitrant and refractory CRS, and discuss the productivity costs associated with CRS. RECENT FINDINGS: Recent studies evaluating anti-IL-4 receptor α antibodies and calcium channel blockers have demonstrated promising early results during management of CRS. Recent appropriateness criteria have been developed to assist clinicians with defining which patients have 'refractory' CRS and may be considered candidates for endoscopic sinus surgery...
February 2017: Current Opinion in Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27888909/topical-therapies-for-refractory-chronic-rhinosinusitis
#15
REVIEW
Akshay Sanan, Mindy Rabinowitz, Marc Rosen, Gurston Nyquist
Topical therapy has become an important tool in the otolaryngologist's armamentarium for refractory chronic rhinosinusitis (CRS). Daily high-volume sinonasal saline irrigation and standard metered-dose topical nasal steroid therapy are supported by the most evidence. Nonstandard topical sinonasal steroid therapies are a potential option for refractory CRS. Current evidence recommends against the use of topical antifungal therapy and topical antibiotic therapy delivered using spray and nebulized techniques in routine cases of CRS...
February 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27888519/antibiotics-in-eosinophilic-chronic-rhinosinusitis-rethinking-maximal-antimicrobial-medical-therapy
#16
Ceren Günel, Benjamin S Bleier, Ibrahim Meteoglu
OBJECTIVES/HYPOTHESIS: Eosinophilic chronic rhinosinusitis (eCRS) has recently been recognized as a CRS subtype characterized by inflammation rather than chronic infection. Consequently, the role of antibiotics as a component of maximal medical therapy for eCRS has been called into question. The purpose of this study was to investigate whether the use of antibiotics, which lack any secondary anti-inflammatory properties, are useful in the treatment of eCRS. STUDY DESIGN: Prospective individual cohort study...
November 26, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27888123/acute-rhinosinusitis-during-hajj-season-2014-prevalence-of-bacterial-infection-and-patterns-of-antimicrobial-susceptibility
#17
Osama A Marglani, Ameen Z Alherabi, Islam R Herzallah, Faisal A Saati, Enas A Tantawy, Talal A Alandejani, Hani S Faidah, Naif A Bawazeer, Abdullah A Marghalani, Tariq A Madani
BACKGROUND: The presence of large number of pilgrims during Hajj in Makkah region increases the risk of respiratory diseases. In this study, we aimed to assess the bacteriology of acute rhinosinusitis (ARS) during Hajj season and to demonstrate the antimicrobial susceptibility patterns that should guide the clinicians towards more appropriate antibiotic use. METHODS: Patients with ARS presenting during Hajj season of 2014 were prospectively enrolled. According to EPOS2012 criteria...
November 2016: Travel Medicine and Infectious Disease
https://www.readbyqxmd.com/read/27879058/sinus-surgery-can-improve-quality-of-life-lung-infections-and-lung-function-in-patients-with-primary-ciliary-dyskinesia
#18
Mikkel Christian Alanin, Kasper Aanaes, Niels Høiby, Tania Pressler, Marianne Skov, Kim Gjerum Nielsen, Helle Krogh Johansen, Christian von Buchwald
BACKGROUND: Chronic rhinosinusitis (CRS) and bacterial sinusitis are ubiquitous in patients with primary ciliary dyskinesia (PCD). From the sinuses, Pseudomonas aeruginosa can infect the lungs. METHODS: We studied the effect of endoscopic sinus surgery (ESS) on symptoms of CRS and lower airway infections in PCD patients in a prospective single-arm intervention study of ESS with adjuvant therapy using nasal irrigation with saline, topical nasal steroids, and 2 weeks of systemic antibiotics...
November 23, 2016: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/27846022/postoperative-care-in-endoscopic-sinus-surgery-a-critical-review
#19
Philippe Eloy, Peter Andrews, Anne-Lise Poirrier
PURPOSE OF REVIEW: Chronic rhinosinusitis with and without nasal polyps is a common disease affecting people all over the world. Functional endoscopic sinus surgery (FESS) has become the gold standard treatment for medically refractive disease. Postoperative care is recommended by international leaders as an important part of the patient's management. This article is a critical review and discussion focusing on postoperative care, which is based on expert opinion, clinical studies, randomized controlled trials and meta-analysis studies...
February 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/27810560/intranasal-delivery-of-ciprofloxacin-to-rats-a-topical-approach-using-a-thermoreversible-in-situ-gel
#20
Joana Sousa, Gilberto Alves, Paula Oliveira, Ana Fortuna, Amílcar Falcão
Intranasal administration of antibiotics is an alternative and attractive delivery approach in the treatment of local infections such as chronic rhinosinusitis. This topical route has the advantage of delivering high drug concentrations directly to the site of infection when trying to eradicate the highly resistant bacterial biofilms. The purpose of this study was to assess and compare the pharmacokinetic parameters of ciprofloxacin following intranasal and intravenous administrations to rats in plasma, olfactory bulb and nasal mucosa of two different nasal regions...
January 15, 2017: European Journal of Pharmaceutical Sciences
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