Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-26T18:33:31.475Z Has data issue: false hasContentIssue false
  • English
  • Français

Comparative study of the efficacy of topical steroid and antibiotic combination therapy versus oral antibiotic alone when treating acute rhinosinusitis

Published online by Cambridge University Press:  14 April 2015

D M El-Hennawi ,
M R Ahmed ,
A M Farid  and
A M Al Murtadah
D M El-Hennawi
Affiliation:
Otolaryngology Unit, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
M R Ahmed*
Affiliation:
Otolaryngology Unit, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
A M Farid
Affiliation:
Otolaryngology Unit, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
A M Al Murtadah
Affiliation:
Otolaryngology Unit, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
*
Address for correspondence: Dr M R Ahmed, Otolaryngology Unit, Faculty of Medicine, Suez Canal University, Ismailia, Egypt Fax: +20 66 3415603 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Acute rhinosinusitis arises as a consequence of viral rhinitis, and bacterial infection can subsequently occur. Intranasal antibiotics as an adjunct to corticosteroids usually demonstrate the greatest symptom relief.

Aim:

We wanted to clinically evaluate the effects of a topical antibiotic and steroid combination administered intranasally, versus an oral antibiotic alone when treating acute rhinosinusitis.

Method:

Forty patients with acute bacterial rhinosinusitis were divided into two groups. Group A received an antibiotic and steroid combination (ofloxacin 0.26 per cent and dexamethasone 0.053 per cent nasal drops) for 10 days, administered intranasally (5 drops in each nostril/8 hours). Group B, the control group, received an oral antibiotic alone (amoxicillin 90 mg/kg).

Results:

Eight hours after commencing treatment, facial pain was more severe in group B and nasal obstruction was reduced in both groups. Ten days after commencing treatment, anterior nasal discharge was 0.15 per cent in group A and absent in group B.

Conclusion:

The application of a topical antibiotic and steroid combination into the nasal cavity is an effective way of treating uncomplicated, acute bacterial rhinosinusitis with the theoretical advantages of easy administration, high local drug concentration and minimal systemic adverse effects.

Keywords

SinusitisRhinitisAnti-Bacterial AgentsBacterial InfectionsSteroidsAdministrationIntranasalAbsorptionPhysiologicalRandomized Controlled Trial
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 5 , May 2015 , pp. 462 - 467
Copyright
Copyright © JLO (1984) Limited 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Cvetnić, V, Cvetnić, S, Sanković, F, Herceg, M, Sipus, N. Microscopic and ultramicroscopic alterations of the respiratory mucous membrane in experimentally provoked bronchitis. Rhinology 1978;16:41–7Google ScholarPubMed
2Drettner, B. The role of the nose in the functional unit of the respiratory system. Rhinology 1979;17:3–11Google ScholarPubMed
3Shin, SH, Heo, WW. Effects of unilateral naris closure on the nasal and maxillary sinus mucosa in rabbit. Auris Nasus Larynx 2005;32:139–43CrossRefGoogle ScholarPubMed
4Meltzer, EO, Teper, A, Danzig, M. Intranasal corticosteroids in the treatment of acute rhinosinusitis. Curr Allergy Asthma Rep 2008;8:133–8CrossRefGoogle ScholarPubMed
5Meltzer, EO, Hamilos, DL, Hadley, JA, Lanza, DC, Marple, BF, Nicklas, RA et al. Rhinosinusitis: establishing definitions for clinical research and patient care. J Allergy Clin Immunol 2004;114:155–212CrossRefGoogle ScholarPubMed
6Stammberger, H, Posawetz, W. Functional endoscopic sinus surgery. Concept, indications and results of the Messerklinger technique. Eur Arch Otorhinolaryngol 1990;247:63–76CrossRefGoogle ScholarPubMed
7Demoly, P. Safety of intranasal corticosteroids in acute rhinosinusitis. Am J Otolaryngol 2008;29:403–13CrossRefGoogle ScholarPubMed
8Cankaya, H, Ozen, S, Kiroğlu, F, Yurttaş, V. Effects of topical chlorhexidine applied to the rabbit nasalmucosa. Auris Nasus Larynx 2003;30:65–9CrossRefGoogle Scholar
9Davidson, TM, Murphy, C, Mitchell, M, Smith, C, Light, M. Management of chronic sinusitis in cystic fibrosis. Laryngoscope 1995;105:354–8CrossRefGoogle ScholarPubMed
10Meltzer, EO, Jalowayski, AA, Orgel, HA, Harris, AG. Subjective and objective assessments in patients with seasonal allergic rhinitis: effects of therapy with mometasone furoate nasal spray. J Allergy Clin Immunol 1998;102:39–49CrossRefGoogle ScholarPubMed
11Mygind, N. Advances in the medical treatment of nasal polyps. Allergy 1999;54 (suppl 53):12–16CrossRefGoogle ScholarPubMed
12Meltzer, EO, Charous, BL, Busse, WW, Zinreich, SJ, Lorber, RR, Danzig, MR. Added relief in the treatment of acute recurrent sinusitis with adjunctive mometasone furoate nasal spray. The Nasonex Sinusitis Group. J Allergy Clin Immunol 2000;106:630–7CrossRefGoogle ScholarPubMed
13Dolor, RJ, Witsell, DL, Hellkamp, AS, Williams, JW Jr, Califf, RM, Simel, DL et al. Comparison of cefuroxime with or without intranasal fluticasone for the treatment of rhinosinusitis. The CAFFS Trial: a randomized controlled trial. JAMA 2001;286:3097–105CrossRefGoogle ScholarPubMed
14Nayak, AS, Settipane, GA, Pedinoff, A, Charous, BL, Meltzer, EO, Busse, WW et al. Effective dose range of mometasone furoate nasal spray in the treatment of acute rhinosinusitis. Ann Allergy Asthma Immunol 2002;89:271–8CrossRefGoogle ScholarPubMed
15Barlan, IB, Erkan, E, Bakir, M, Berrak, S, Başaran, MM. Intranasal budesonide spray as an adjunct to oral antibiotic therapy for acute sinusitis in children. Ann Allergy Asthma Immunol 1997;78:598–601CrossRefGoogle ScholarPubMed
16Yilmaz, G, Varan, B, Yilmaz, T, Gürakan, B. Intranasal budesonide spray as an adjunct to oral antibiotic therapy for acute sinusitis in children. Eur Arch Otorhinolaryngol 2000;257:256–9Google ScholarPubMed
17Meltzer, EO, Orgel, HA, Backhaus, JW, Busse, WW, Druce, HM, Metzger, WJ et al. Intranasal flunisolide spray as an adjunct to oral antibiotic therapy for sinusitis. J Allergy Clin Immunol 1993;92:812–23CrossRefGoogle ScholarPubMed
18Williamson, IG, Rumsby, K, Benge, S, Moore, M, Smith, PW, Cross, M et al. Antibiotics and topical nasal steroid for treatment of acute maxillary sinusitis: a randomized controlled trial. JAMA 2007;298:2487–96CrossRefGoogle ScholarPubMed
19Garbutt, JM, Banister, C, Spitznagel, E, Piccirillo, JF. Amoxicillin for acute rhinosinusitis: a randomized controlled trial. JAMA 2012;307:685–92CrossRefGoogle ScholarPubMed
20Castellanos, J, Axelrod, D. Flexible fiberoptic rhinoscopy in the diagnosis of sinusitis. J Allergy Clin Immunol 1989;83:91–4CrossRefGoogle ScholarPubMed
21Bluestone, CD. Efficacy of ofloxacin and other ototopical preparations for chronic suppurative otitis media in children. Pediatr Infect Dis J 2001;20:111–5CrossRefGoogle ScholarPubMed
22Gates, GA. Safety of ofloxacin otic and other ototopical treatments in animal models and in humans. Pediatr Infect Dis J 2001;20:104–7CrossRefGoogle ScholarPubMed
23Klein, JO. In vitro and in vivo antimicrobial activity of topical ofloxacin and other ototopical agents. Pediatr Infect Dis J 2001;20:102–3CrossRefGoogle ScholarPubMed
24Richter, SS, Brueggemann, AB, Huynh, HK, Rhomberg, PR, Wingert, EM, Flamm, R et al. A 1997–1998 national surveillance study: Moraxella catarrhalis and Haemophilus influenzae antimicrobial resistance in 34 US institutions. Int J Antimicrob Agents 1999;13:99–107CrossRefGoogle ScholarPubMed
25Vaughan, WC, Carvalho, G. Use of nebulized antibiotics for acute infections in chronic sinusitis. Otolaryngol Head Neck Surg 2002;127:558–68CrossRefGoogle ScholarPubMed
26Wahl, KJ, Otsuji, A. New medical management techniques for acute exacerbations of chronic rhinosinusitis. Curr Opin Otolaryngol Head Neck Surg 2003;11:27–32CrossRefGoogle ScholarPubMed
27Scheinberg, PA, Otsuji, A. Nebulized antibiotics for the treatment of acute exacerbations of chronic rhinosinusitis. Ear Nose Throat J 2002;81:648–52CrossRefGoogle ScholarPubMed
28Solares, CA, Batra, PS, Hall, GS, Citardi, MJ. Treatment of chronic rhinosinusitis exacerbations due to methicillin-resistant Staphylococcus aureus with mupirocin irrigations. Am J Otolaryngol 2006;27:161–5CrossRefGoogle ScholarPubMed
29Small, CB, Bachert, C, Lund, VJ, Moscatello, A, Nayak, AS, Berger, WE. Judicious antibiotic use and intranasal corticosteroids in acute rhinosinusitis. Am J Med 2007;120:289–94CrossRefGoogle ScholarPubMed
30Giger, R, Pasche, P, Cheseaux, C, Cantini, L, Rossetti, A, Landis, BN et al. Comparison of once- versus twice-daily use of beclomethasone dipropionate aqueous nasal spray in the treatment of allergic and non-allergic chronic rhinosinusitis. Eur Arch Otorhinolaryngol 2003;260:135–40CrossRefGoogle ScholarPubMed