State of the Art Review: Current Status of Topical Nasal Antimicrobial Agents

Abstract

The nasal cavity and paranasal sinuses are probably one of the last frontiers in the head and neck region where the use of topical antimicrobial agents is not yet established. Although the anatomy of the nasal cavity and the paranasal sinuses can theoretically be exploited for the administration of antimicrobials in rhinosinusitis, very few studies have been conducted to test the feasibility of this mode of therapy. We review the anatomical and physiological factors that should be considered in the use of topical nasal antimicrobial agents and the current status of topical nasal antimicrobial usage, and we make recommendations for the administration of topical nasal antimicrobial agents.

Topical Membrane Therapy for Chronic Rhinosinusitis

“…In CRS though, the chronic infection impairs the ciliary function, in favor of the prolonged residence of topically delivered medications. On the other hand, it is suggested that the active transfer of medications to the choanae might actually enhance their distribution to remote mucosal subsites (Goh and Goode, 2000).…”

Role of antibiotics in sinusitis

“…Although oral and intravenous deliveries consistently achieve the therapeutic minimum inhibitory concentration (MIC) for the common pathogens of CRS in the sinonasal mucosa [46,47], topical administrations can localize drug delivery to the sinonasal cavity and minimize the systemic effects of the antibiotics [48,49]. Although oral and intravenous deliveries consistently achieve the therapeutic minimum inhibitory concentration (MIC) for the common pathogens of CRS in the sinonasal mucosa [46,47], topical administrations can localize drug delivery to the sinonasal cavity and minimize the systemic effects of the antibiotics [48,49].…”

Effect of 2% Nasal Mupirocin Ointment on Decreasing Complications of Nasotracheal Intubation: A Randomized Controlled Trial

“…In addition, several studies have shown that prophylactic use of mupirocin ointment within the nasal cavity in S. aureus carriers decreases the risk of infection of the surgical site, alleviate problems in ICU patients, who undergo intubation for a long duration [3,4,[10][11][12]. However, except for the study by Takahashi S et al, no comprehensive study has been carried out to evaluate the efficacy of this ointment.…”

“…Thus, in case of favourable effects this ointment can be used in all the surgeries that are associated with nasal intubation to decrease the complications of the procedure, especially in compromised patients. It should be pointed out that no studies to date have reported any major side effects associated with the use of mupirocin ointment and the complications have been confined to minor irritation of the nasal mucosa that is resolved after discontinuation of the use of the ointment [4,10].…”