Management of rhinosinusitis in Dutch general practice

Abstract

Aims: To determine whether general practitioners (GPs) distinguish between the management of acute rhinosinusitis (ARS) and chronic rhinosinusitis (CRS), especially with regard to prescription of antibiotics and nasal steroids.Methods: A questionnaire on the management of rhinosinusitis was sent to 1000 GPs in the Netherlands.Results: Ninety-six percent discriminated between ARS and CRS. However, the definition of ARS and CRS varied. The percentage of GPs prescribing antibiotics rose as rhinosinusitis severity increased. The prescription rate of nasal corticosteroids was highest for CRS (88.6%). Prescribing nasal corticosteroids in ARS was not very common.Conclusions: Most GPs discriminate between ARS and CRS and 54% accepted (the EP3OS-defined) 12 weeks as the division between ARS and CRS. Antibiotics and nasal steroids are commonly used agents, but the management of rhinosinusitis is not always consistent with guidelines.

High costs and burden of illness in acute rhinosinusitis: real-life treatment patterns and outcomes in Swedish primary care

“…15 The use of decongestants was approximately three times more common than in our study, which is interesting as the evidence level is low for the efficacy of decongestants in mild to moderate disease. 4,5 However, only one-third of the GPs in the Dutch study considered prescribing intranasal corticosteroids in mild or moderate acute rhinosinusitis.…”

“…A recent study performed in the Netherlands using questionnaires sent to GPs showed that oral antibiotics were prescribed by approximately one-third of the practitioners for mild and moderate acute rhinosinusitis. 15 In the current study, we found that antibiotic treatment was common, despite national programmes to reduce its use. 20 The most recent Cochrane update emphasised that antibiotics have a limited treatment effect in acute rhinosinusitis and stated that most cases will resolve without antibiotics within 2 weeks.…”

“…14 However, a recent questionnaire study performed in the Netherlands showed that current treatment patterns might have changed, as the antibiotic prescription frequency in that study was 20% and 34% for mild and moderate acute rhinosinusitis, respectively. 15 Few studies investigating the impact of acute rhinosinusitis on disease-specific quality of life have been performed and generic quality of life data are limited. 16 Furthermore, to our knowledge, the costs for acute rhinosinusitis have not previously been investigated in Scandinavia.…”

Antibiotic efficacy in patients with a moderate probability of acute rhinosinusitis: a systematic review

“…Viruses cause most ARS, but discriminating between viral and bacterial rhinosinusitis is challenging and impossible in daily practice. In consequence, too many patients with ARS receive antibiotics [1][2][3]. Expert consensus guidelines recommend antibiotics only for patients with severe symptoms persisting for 10 days or more or for worsening of symptoms after initial improvement [4,5,1].…”

Rhinosinusitis: classification, epidemiology, etiology and treatment

“…Среди женщин она была выше, чем среди мужчин, -2 310 против 1 440 на 100 000 населения. У большинства пациентов, вошедших в исследование (69,0%), был зарегистрирован один эпи-зод риносинусита, у 19,0% -один рецидив и лишь у 12,0% -2 и более [14].…”