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

Mainz, Jochen G.; Jaudszus, Anke; Pletz, Mathias W.

doi:10.1080/17512433.2018.1524753

Cited by 5 publications

(4 citation statements)

References 19 publications

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“…Often doctors prescribe antibiotics in almost all cases of acute rhinosinusitis, antibiotics prescribed in patient visits range from 82-88%, this is due to difficulties in the diagnostic enforcement of acute rhinosinusitis of viruses or bacteria due to similar clinical symptoms [1][2][3] . Streptococcus pneumoniae (20-45%), Haemophilus influenzae (20-43%), Moraxella catarrhalis (14-28%), and Staphylococcus aureus (8-11%) often the cause of acute rhinosinusitis 4 Antibiotics should not be routinely prescribed for therapy in acute rhinosinusitis as they may contribute to an increasing spectrum of antibiotic resistance, so proper diagnosis and proper therapy are expected to prevent overuse of antibiotics and resistance due to unwise use of antibiotics.…”

Section: Introductionmentioning

confidence: 99%

Effect of Moringa Leaf Ethanol Extract on Reduced Levels of Mda, TNF-α and Description of Inflammatory Cells in Rat Sinus Mucosa Model of Acute Rhinosinusitis

Wardani

Purwanto

DonoIndarto

et al. 2022

Bangladesh J Med Sci

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Background: Symptoms and signs of acute viral and bacterial rhinosinusitis that are not specific cause difficulties in diagnostic enforcement, causing difficulties in administering therapy, so often doctors provide antibiotic therapy on acute viral rhinosinusitis. Irrelevant antibiotics will cause frequent antibiotic resistance. Adjuvant therapy is required to prevent infections that continue to become chronic, shorten the duration of infection, and avoid unwanted complications. Moringa leaves (M. oleifera)contains antioxidant components that can help rebalance redox metabolism and reduce excess free radicals so as to prevent oxidative stress. Method: posttest only control group research design. Male strain Sprague Dawley white rat was maintained and treated at the Nutrition Laboratory of the Center for Food and Nutrition Studies of Gadjah Mada University (UGM). Mice were divided into 4 groups. Group 1: standard feed., group 2: standard feed and staphylococcus-induced aureus, group 3: standard feed, Staphylococcus aureus-induced given amoxicillin dose of 27 mg/day, group 4: standard feed, Staphylococcus aureus-induced was given amoxicillin dose of 27 mg/day and given (EEDK) 200 mg/KgBW/day. Data analysis Of Normality test using Shapiro-Wilk Test and homogeneity using Levene’s Test obtained results p>0.05. Then conducted One Way AnovaTest obtained p<0.05 and continued with post-hoc LSD test. The data is analyzed using SPSS 25.0 for Windows. Result: MDA test Anova obtained p value (Sig.) = 0.000 (p< 0.05), Post Hoc with LSD all groups (p-value) < 0.05, indicated a significant mean difference in average MDA levels among all groups. The lowest mean difference in MDA levels in group K with P3 was 0.92 pg/mL; while P1 with P3 has the largest average MDA rate difference of 7.47 pg/mL. TNF-α Anova test obtained p value (Sig.) = 0.000 (p< 0.05), Post Hoc with LSD of all groups (p-value= 0.000) < 0.05, there is a meaningful difference in the average level of TNF-α between all groups. The smallest average difference in TNF-α levels in group K with P3 was 0.31 pg/mL; while P1 with P3 has the largest average TNF-α rate of 5.01 pg/mL. Description of inflammation of the mucosa cavum rice and sinus K score 0; P1 score 3; P2 score 2; P3 score 1. Conclusion: Moringa leaf ethanol extract in this study can be used as adjuvant therapy because it can lower MDA and TNF-α levels in mice induced with Staphylococcus aureus along with amoxicillin standard therapy. Extract ethanol moringa leaves in this study can be used as adjuvant therapy because it can lower the score of inflammatory cells better than by only given standard therapy only Bangladesh Journal of Medical Science Vol. 21 No. 02 April’22 Page : 311-317

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Section: Introductionmentioning

confidence: 99%

Effect of Moringa Leaf Ethanol Extract on Reduced Levels of Mda, TNF-α and Description of Inflammatory Cells in Rat Sinus Mucosa Model of Acute Rhinosinusitis

Wardani

Purwanto

DonoIndarto

et al. 2022

Bangladesh J Med Sci

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“…Systemic over-usage of antibiotics might cause many side effects, but also leads to an increase in antibiotic resistance [ 16 – 18 ] with potential global consequences and thus poses a threat to the health of the general population [ 19 ]. An appropriate tool in medical practice, one which would make the decision-making process more precise to determine whether there is a need of use of antibiotics in treatment of sinonasal infections, would validly contribute to reduce the excessive overconsumption of antibiotics worldwide [ 8 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical decision support system RHINA in the diagnosis and treatment of acute or chronic rhinosinusitis

Hart

Polášková

Schalek

2021

BMC Med Inform Decis Mak

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Background Rhinosinusitis is an inflammation of the sinonasal cavity which affects roughly one in seven people per year. Acute rhinosinusitis (ARS) is mostly, apart from allergic etiology, caused by a viral infection and, in some cases (30–50%), by a bacterial superinfection. Antibiotics, indicated only in rare cases according to EPOS guidelines, are nevertheless prescribed in more than 80% of ARS cases, which increases the resistant bacterial strains in the population. Methods We have designed a clinical decision support system (CDSS), RHINA, based on a web application created in HTML 5, using JavaScript, jQuery, CCS3 and PHP scripting language. The presented CDSS RHINA helps general physicians to decide whether or not to prescribe antibiotics in patients with rhinosinusitis. Results In a retrospective study of a total of 1465 patients with rhinosinusitis, the CDSS RHINA presented a 90.2% consistency with the diagnosis and treatment made by the ENT specialist. Conclusion Patients assessed with the assistance of our CDSS RHINA would decrease the over-prescription of antibiotics, which in turn would help to reduce the bacterial resistance to the most commonly prescribed antibiotics.

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“…Systemic over-usage of antibiotics might cause many side effects, but also leads to an increase in antibiotic resistance [16][17][18] with potential global consequences and thus poses a threat to the health of the general population [19]. An appropriate tool in medical practice, one which would make the decisionmaking process more precise to determine whether there is a need of use of antibiotics in treatment of sinonasal infections, would validly contribute to reduce the excessive overconsumption of antibiotics worldwide [8,20].…”

Section: Introductionmentioning

confidence: 99%

Clinical decision support system RHINA in the diagnosis and treatment of acute or chronic rhinosinusitis

Hart¹,

Polášková

Schalek³

2021

Preprint

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Background: Rhinosinusitis is an inflammation of the sinonasal cavity which affects roughly one in seven people per year. Upper respiratory tract infection (RTI) is mostly, apart from allergic etiology, caused by a viral infection and, in some cases (0.2 - 2 %), by a bacterial superinfection. Antibiotics, indicated only in rare cases according to EPOS guidelines, are nevertheless prescribed in more than 80% of ARS cases, which increases the resistant bacterial strains in the population. Methods: We have designed a clinical decision support system (CDSS), RHINA, based on a web application created in HTML 5, using JavaScript, jQuery, CCS3 and PHP scripting language. The presented CDSS RHINA helps general physicians to decide whether or not to prescribe antibiotics in patients with rhinosinusitis.Results: In a retrospective study of a total of 1,465 patients with rhinosinusitis, the CDSS RHINA presented a 90.2% consistency with the diagnosis and treatment made by the ENT specialist. Conclusion: Patients assessed with the assistance of our CDSS RHINA would decrease the over-prescription of antibiotics, which in turn would help to reduce the bacterial resistance to the most commonly prescribed antibiotics.

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

Cited by 5 publications

References 19 publications

Effect of Moringa Leaf Ethanol Extract on Reduced Levels of Mda, TNF-α and Description of Inflammatory Cells in Rat Sinus Mucosa Model of Acute Rhinosinusitis

Effect of Moringa Leaf Ethanol Extract on Reduced Levels of Mda, TNF-α and Description of Inflammatory Cells in Rat Sinus Mucosa Model of Acute Rhinosinusitis

Clinical decision support system RHINA in the diagnosis and treatment of acute or chronic rhinosinusitis

Clinical decision support system RHINA in the diagnosis and treatment of acute or chronic rhinosinusitis

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