Amoxicillin‐clavulanate for patients with acute exacerbation of chronic rhinosinusitis: a prospective, double‐blinded, placebo‐controlled trial

Sabino, Henrique Augusto Cantareira; Valera, Fabiana Cardoso Pereira; Aragon, Davi Casale; Fantucci, Marina Zílio; Titoneli, Carolina Carneiro; Martínez, Roberto; Anselmo‐Lima, Wilma Terezinha; Tamashiro, Edwin

doi:10.1002/alr.21846

Cited by 30 publications

(34 citation statements)

References 23 publications

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“…In the treatment of CRS exacerbations, sinus cultures are often obtained to guide treatment with antibiotics. Although it has been suggested that antibiotics may not change the clinical course of disease, expert opinion and consensus guidelines have favored the use of short‐term antibiotics for acute CRS exacerbations in the setting of a positive culture . Endoscopic‐guided cultures and use of culture‐directed antibiotics result in improved sinonasal symptoms and QOL outcome scores, although this has not been directly compared to empiric antibiotics .…”

mentioning

confidence: 99%

Comparison of outcomes following culture‐directed vs non–culture‐directed antibiotics in treatment of acute exacerbations of chronic rhinosinusitis

Yan

Tangbumrungtham

Maul

et al. 2018

Int Forum Allergy Rhinol

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confidence: 99%

Comparison of outcomes following culture‐directed vs non–culture‐directed antibiotics in treatment of acute exacerbations of chronic rhinosinusitis

Yan

Tangbumrungtham

Maul

et al. 2018

Int Forum Allergy Rhinol

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“…Thus, in a double-blinded placebo-controlled trial, Sabino et al found that a CRS treatment based on the combination of 2 weeks of amoxycillin/clavulanate, nasal irrigations, and intranasal corticosteroids was associated with a significant improvement in the SNOT-22 score at 12 weeks and a success rate from 45% to 50%. 25 The comparison with our study can be biased because the therapeutic period of that investigation was shorter than that of our study (2 vs 8 weeks). In addition, the researchers included patients with CRS and nasal polyps, and the success rate criteria were based only on the endoscopic clinical findings.…”

Section: Discussionmentioning

confidence: 58%

A 10-Year Follow-Up of a Randomized Prospective Study of 2 Treatments for Chronic Rhinosinusitis Without Nasal Polyps and Investigation of the Impact of Gastroeosophageal Reflux Disease in the Resistance to Treatment

et al. 2019

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Objectives: To compare the 2 long-term medical strategies in chronic rhinosinusitis without nasal polyps (CRSnNP) and to identify the role of gastroesophageal reflux disease (GERD) and Helicobacter pylori as factors of treatment failure. Material and Methods: Fifty-seven patients with CRSnNP were randomized into 2 therapeutic groups. The first group was treated with 4 weeks of amoxicillin/clavulanate and a short course of oral steroids. The second group received 8 weeks of clarithromycin. Sinonasal Outcome Test-20 (SNOT-20) and Lund and Mackay scores were assessed at baseline and after treatment, and GERD Health-Related Quality of Life (GERD-HRQL) questionnaire was evaluated in all patients. Patients with a GERD-HRQL score >8 received esogastroscopy and H pylori detection. Patients were followed during a 10-year period for clinical course and GERD evolution. The 10-year evolution of patients was described in terms of recurrence, medical, and surgical treatments. Results: Thirty-seven patients completed the study; SNOT-20 and Lund and Mackay scores similarly improved in both groups. Amoxicillin/clavulanate group had significantly more adverse reactions than the clarithromycin group (P = .03). After the therapeutic course, 35% (amoxicillin/clavulanate) and 41% (clarithromycin) of patients needed functional endoscopic sinus surgery (FESS). During the long-term follow-up, 54% (amoxicillin/clavulanate) and 40% (clarithromycin) of patients had late CRSnNP recurrence; FESS was performed in less than 15% of cases of recurrence. Gastroesophageal reflux disease complaint’s severity was associated with late recurrence of CRSnNP. Conclusion: Amoxicillin/clavulanate and clarithromycin would be competitive treatments for CRSnNP. Gastroesophageal reflux disease seems to be a negative factor for treatment response and recurrence.

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“…None of the maxillary antral specimen that grew fungus was positive for bacteria growth. Amoxicillin and trimethoprim-sulfamethoxazole [Bactrim, Septrim]) have been recommended for use in the management of uncomplicated, acute bacterial rhinosinusitis (43,44). Trimethoprimsulfamethoxazole was not included in our antibiotic sensitivity pattern as it was observed from our institution that most organisms have developed resistance to it.…”

Section: Discussionmentioning

confidence: 99%

Aerobic bacteria and fungal isolates in maxillary sinusitis of adults in a resource poor environment

Fasunla¹,

Fayemiwo²,

Bakare³

et al. 2018

Af J Clin Exp Micro

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Background: Infective rhinosinusitis is a common clinical condition which if left unattended to could result in various degrees of both morbidity and mortality. We aimed to identify aerobic and fungal organisms implicated in acute and chronic maxillary sinusitis and determine their antibiotic sensitivity patterns among adults in South Western Nigeria. Materials and methods: This was a cross sectional study of adults with clinical and radiological diagnosis of maxillary sinusitis treated at the University College Hospital, Ibadan over a period of one-year. Semi-structured questionnaire was administered to each consented adult to obtain relevant demographic and clinical data. Maxillary antral proof puncture was done to obtain specimen for microscopy, culture and sensitivity for aerobic bacterial and fungal isolates. Descriptive statistics was used in the data analysis. Results: Seventy-nine patients (49.4% males and 50.6% females) with acute maxillary sinusitis (17.7%), and chronic maxillary sinusitis (82.3%) were recruited into the study. The mean age of the patients was 32.9 years (SD=12.78; Range: 19-59). All patients presented with rhinorrhea while 92.8% had nasal obstruction. Fifty eight (73.4%) patients had history of antibiotic usage before presentation. Eight (57.1%) of the specimens from acute maxillary sinusitis cases and 40 (61.5%) of the specimens from chronic maxillary sinusitis yielded significant growth of bacteria and fungi respectively while 2 (3.5%) yielded mixed bacterial growth. Organisms commonly isolated from these specimens were Streptococcus pneumonia, Staphylococcus aureus, Pseudomonas aeruginosa, Haemophilus influenzae, and Aspergillus spp. The bacteria isolates were sensitive to Amoxicillin, Ciprofloxacin, Perfloxacin, Sparfloxacin and Ceftriaxone. Conclusion: The leading aerobic bacterial isolates from acute and chronic maxillary sinusitis were Streptococcus pneumonia and Staphylococcus aureus respectively. Fungal infections are seen only in chronic cases. It is recommended that where there are no microbiologic laboratory facilities, any of Ciprofloxacin, Perfloxacin, Sparfloxacin, and Amoxicillin can be administered empirically to treat infective maxillary sinusitis.

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Amoxicillin‐clavulanate for patients with acute exacerbation of chronic rhinosinusitis: a prospective, double‐blinded, placebo‐controlled trial

Abstract: We concluded that AMX-CLAV for 14 days did not change the clinical course of AECRS compared with placebo. The addition of an oral antibiotic to ongoing topical intranasal steroid spray may not provide additional benefit during management of AECRS.

Cited by 30 publications

References 23 publications

Comparison of outcomes following culture‐directed vs non–culture‐directed antibiotics in treatment of acute exacerbations of chronic rhinosinusitis

Comparison of outcomes following culture‐directed vs non–culture‐directed antibiotics in treatment of acute exacerbations of chronic rhinosinusitis

A 10-Year Follow-Up of a Randomized Prospective Study of 2 Treatments for Chronic Rhinosinusitis Without Nasal Polyps and Investigation of the Impact of Gastroeosophageal Reflux Disease in the Resistance to Treatment

Aerobic bacteria and fungal isolates in maxillary sinusitis of adults in a resource poor environment

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