Current diagnosis and management of sinusitis

Willett, Laura Rees; Carson, Jeffrey L.; Williams, John W

doi:10.1007/bf02599141

Cited by 46 publications

(22 citation statements)

References 141 publications

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“…Acute bacterial sinusitis is most commonly caused by Streptococcus pneumoniae and Haemophilus influenzae, which account for 50-65% of cases of acute maxillary sinusitis (AMS) in adults [5]. Other pathogens less frequently identified include Moraxella catarrhalis, betahaemolytic streptococci, Staphylococcus aureus and anerobic bacteria, which are often associated with dental infection [5].…”

Section: Introductionmentioning

confidence: 99%

“…Other pathogens less frequently identified include Moraxella catarrhalis, betahaemolytic streptococci, Staphylococcus aureus and anerobic bacteria, which are often associated with dental infection [5]. Treatment of acute sinusitis is typically initiated with a combination of empiric antimicrobials and nasal decongestants, aimed at eradicating the underlying infection and improving drainage, respectively.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy and Tolerability of Once-Daily Therapy with Telithromycin for 5 or 10 Days for the Treatment of Acute Maxillary Sinusitis

Roos¹,

Brunswig-Pitschner²,

Kostřica³

et al. 2002

Chemotherapy

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Background: The efficacy and tolerability of oral telithromycin 800 mg once daily for 5 vs. 10 days were assessed in patients with acute maxillary sinusitis (AMS). Methods: Adults (n = 341) with confirmed AMS diagnosed on clinical signs and symptoms and sinus X-ray showing total opacity or air-fluid level were randomized to receive oral telithromycin for 5 days (followed by placebo for 5 days; n = 170) or 10 days (n = 171). Causative pathogens were isolated by pretreatment sinus puncture (day 1). Clinical and bacteriologic outcomes, and safety and tolerability endpoints were assessed. Results: Clinical cure rates post-therapy (per-protocol; days 17–21) were comparable (91.1% in the 5-day group, n = 123; 91.0% in the 10-day group, n = 133). Bacteriologic eradication rates (per-protocol) were also similar (90.7 vs. 91.3%). Both regimens were well tolerated. Conclusions: A 5-day course of telithromycin 800 mg once daily is an effective, well-tolerated treatment for adults with AMS, comparable to a 10-day regimen.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficacy and Tolerability of Once-Daily Therapy with Telithromycin for 5 or 10 Days for the Treatment of Acute Maxillary Sinusitis

Roos¹,

Brunswig-Pitschner²,

Kostřica³

et al. 2002

Chemotherapy

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“…About a quarter showed only mucosal thickening on radiography (Dolor RJ, personal communication): a finding that is nonspecific and often seen in allergic or viral illness. 3 This study does not prove that fluticasone speeds resolution of acute bacterial sinusitis unrelated to atopy. However, these conditions frequently coexist, and differentiating between them may be difficult.…”

Section: Commentarymentioning

confidence: 65%

Adding intranasal fluticasone to cefuroxime resolved acute rhinosinusitis

Willett

2002

Evidence-Based Medicine

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“…Levofloxacin did not sustain bacterial killing and did not prevent the emergence of further resistance in mutants with the parC or parE mutation or both mutations, even though an unbound AUC:MIC ratio for exposure well above the breakpoint of 30 to 40 established in the literature for S. pneumoniae was maintained. Moxifloxacin was effective against all isolates tested, despite the presence of isolates with two-and three-step mutations, for which the MICs were increased.Streptococcus pneumoniae is the most common organism associated with lower respiratory tract infections and accounts for approximately 50% of all cases of community-acquired pneumonia, 35% of cases of acute sinusitis and acute otitis media, and 20% of chronic bronchitis infections (15,28). Of growing concern with S. pneumoniae is the increasing levels of resistance to commonly used antimicrobials, namely, the penicillins and other ␤-lactams, as well as the macrolides.…”

mentioning

confidence: 99%

“…Streptococcus pneumoniae is the most common organism associated with lower respiratory tract infections and accounts for approximately 50% of all cases of community-acquired pneumonia, 35% of cases of acute sinusitis and acute otitis media, and 20% of chronic bronchitis infections (15,28). Of growing concern with S. pneumoniae is the increasing levels of resistance to commonly used antimicrobials, namely, the penicillins and other ␤-lactams, as well as the macrolides.…”

mentioning

confidence: 99%

Pharmacodynamics of Moxifloxacin and Levofloxacin at Simulated Epithelial Lining Fluid Drug Concentrations against Streptococcus pneumoniae

Florea

Tessier²,

Zhang³

et al. 2004

Antimicrob Agents Chemother

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Recent clinical failures associated with levofloxacin treatment for Streptococcus pneumoniae infections and growing evidence of frequent mutations in the isolate population have led to increased concerns regarding fluoroquinolone resistance. Our objective was to characterize the efficacies of levofloxacin and moxifloxacin against various genotypes of S. pneumoniae after simulated bronchopulmonary exposures. An in vitro model was used to simulate a levofloxacin concentration of 500 mg and a moxifloxacin concentration of 400 mg, which were previously determined to be the concentrations in the epithelial lining fluid of older adults receiving once-daily dosing. The effects of the drugs were tested against six S. pneumoniae containing various mutations. Bacterial density and resistance were quantitatively assessed over 48 h. The S. pneumoniae isolate with no mutation displayed a 4-log reduction in CFU after treatment with both agents and did not develop resistance. Isolates containing the parC or parE mutation or both mutations regrew and developed resistance when they were exposed to levofloxacin, despite an unbound area under the concentration-time curve (AUC):MIC ratio of ϳ100. When the isolate containing the parC and gyrA mutations was exposed to levofloxacin, there was a half-log reduction in the number of CFU compared to that for the control, but the isolate subsequently regrew. Likewise, levofloxacin did not kill the isolate containing the parC, gyrA, and parE mutations. Moxifloxacin sustained the killing of all bacterial isolates tested without the development of resistance. Levofloxacin did not sustain bacterial killing and did not prevent the emergence of further resistance in mutants with the parC or parE mutation or both mutations, even though an unbound AUC:MIC ratio for exposure well above the breakpoint of 30 to 40 established in the literature for S. pneumoniae was maintained. Moxifloxacin was effective against all isolates tested, despite the presence of isolates with two-and three-step mutations, for which the MICs were increased.Streptococcus pneumoniae is the most common organism associated with lower respiratory tract infections and accounts for approximately 50% of all cases of community-acquired pneumonia, 35% of cases of acute sinusitis and acute otitis media, and 20% of chronic bronchitis infections (15,28). Of growing concern with S. pneumoniae is the increasing levels of resistance to commonly used antimicrobials, namely, the penicillins and other ␤-lactams, as well as the macrolides. The frequencies of resistance to penicillin and the macrolides among S. pneumoniae strains are estimated to be 40 and 30%, respectively (10). As such, use of one of the antipneumococcal fluoroquinolones (levofloxacin, moxifloxacin, gatifloxacin) as monotherapy for lower respiratory tract infections is fast becoming common practice in both the inpatient and the outpatient settings.With the increasing use of the antipneumococcal fluoroquinolones, issues surrounding the development of resistance to these agents ...

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Current diagnosis and management of sinusitis

Cited by 46 publications

References 141 publications

Efficacy and Tolerability of Once-Daily Therapy with Telithromycin for 5 or 10 Days for the Treatment of Acute Maxillary Sinusitis

Efficacy and Tolerability of Once-Daily Therapy with Telithromycin for 5 or 10 Days for the Treatment of Acute Maxillary Sinusitis

Adding intranasal fluticasone to cefuroxime resolved acute rhinosinusitis

Pharmacodynamics of Moxifloxacin and Levofloxacin at Simulated Epithelial Lining Fluid Drug Concentrations against Streptococcus pneumoniae

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