A Survey on the Management of Acute Rhinosinusitis Among Asian Physicians

Abstract

INTRODUCTIONAcute rhinosinusitis (ARS) is a significant health problem, being one of the top reasons for a visit to primary care clinics (1) . It was found that an average of 8.4 % of the Dutch population reported at least one episode of ARS per year in 1999 (2) . The incidence of visits to the general practitioner for acute rhinosinusitis in the Netherlands in 2000 was 20 per 1000 men and 33.8 per 1000 women (3) . According to data from a National Ambulatory Medical Care Survey (NAMCS) in the USA, rhinosinusitis is the fifth most common diagnosis SUMMARYBackground: Based on the 'European Position Paper on Rhinosinusitis and Nasal polyps (EP 3 OS 2007)', this study aimed to investigate general practitioners (GPs) and other specialists' understanding when managing patients with acute rhinosinusitis (ARS) in Asia.

Tavipec® in acute rhinosinusitis: a multi-centre, doubleblind, randomized, placebo-controlled, clinical trial

“…Viral ARS is one of the most common reasons why patients seek medical advice in ambulatory care. Although clinical studies have demonstrated that antibiotics are not indicated for treatment of viral ARS, antibiotics are still prescribed at high rates while guideline-oriented management suggests symptomatic treatment and reassurance for patients with mild symptoms (1,(5)(6)(7)(8)(9)(10) . Herbal medicinal products containing plant-derived monoterpenes represent a well-tolerated therapeutic option for uncomplicated upper RTIs based on long-standing use, however, the evidence for beneficial effects of herbal compounds for the treatment of viral ARS is limited and there is a real need for more RCTs in this field (1) .…”

“…Although approximately 98% of ARS are viral and self-limiting, antibiotics are often prescribed in primary care (1,(5)(6)(7)(8)(9)(10)(11) . In fact, only 0.5-2.0% of patients eventually develop acute bacterial rhinosinusitis (ABRS) secondary to a viral infection (1) .…”

“…Monoterpenes are resorbed in the gastrointestinal tract and enter the circulation and reach the mucosal secretory glands, where they have secretolytic effects by enhancing mucus production and ciliary beat frequency (CBF) as well as stimulating ciliary cell differentiation, thus supporting the cleaning function and the recovery process of the mucosa (14,15,22,30,31) . Ciliary impairment and the disruption of the normal mucociliary flow have been demonstrated to be a feature of both viral ARS and ABRS (1,8) .…”

Development of a clinical decision rule for diagnosing sinus infections – to reduce unnecessary antibiotic prescribing

“…To the highest proportion it is provoked by viruses like rhinovirus and coronaviruses but also influenza and parainfluenza, adenovirus, respiratory syncytial virus (RSV), and enterovirus can cause a common cold [1]. In contrast, only 0.5-2% of patients with ARS is estimated to develop acute bacterial sinonasal infection, and this mostly results secondarily to viral RS [4]. In this small proportion of ARS bacteria like S. pneumoniae, H. influenzae, S. aureus, and M. catarrhalis may be detected [5].…”

Evolution of microbial etiology in acute and chronic rhinosinusitis and its role in the current management of antibiotic treatment

“…Lately, there have been reported very high incidences as far as acute rhinosinusitis is concerned. It is estimated that adults suffer two to five episodes of viral ARS per year and only 0.5-2% of ARS are complicated by bacteria infection 1,5,6 . Regarding the epidemiology of chronic rhinosinusitis, recent studies show that almost 15% of the population is affected.…”