Systemic Absorption of Gentamicin Nasal Irrigations

Whatley, Wesley S.; Chandra, Rakesh K.; MacDonald, Charles B.

doi:10.2500/ajr.2006.20.2855

Cited by 35 publications

(33 citation statements)

References 12 publications

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“…Twice-daily irrigation with gentamicin for 3 to 15 weeks caused low but measurable systemic absorption, with blood levels ranging from 0.3 to 0.7 mg/mL. 88 Sensorineural hearing loss was noted in 23% of patients with CF who had used frequent irrigations, 89 and for this reason, the author cautions against use of aminoglycosides for chronic administration, especially greater than once daily. Topical antibiotics can be administered with or without a nebulizer.…”

Section: Crs Relation To Asthma Severitymentioning

confidence: 97%

Chronic rhinosinusitis: Epidemiology and medical management

Hamilos

2011

Journal of Allergy and Clinical Immunology

353

296

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Section: Crs Relation To Asthma Severitymentioning

confidence: 97%

Chronic rhinosinusitis: Epidemiology and medical management

Hamilos

2011

Journal of Allergy and Clinical Immunology

353

296

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“…At previously reported concentrations of the respective antibiotics (150 µg/ml mupirocin, 80 µg/ml gentamicin) in the absence of SinuSurf, no growth was evident [5,6,7,8]. However, a 10-fold dilution of mupirocin and a 100-fold dilution of gentamicin yielded growth while the addition of SinuSurf to these dilutions eradicated growth (fig.…”

Section: Resultsmentioning

confidence: 99%

In vitro Antimicrobial Activity of SinuSurf™

Kofonow

Adappa

2012

ORL

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Background: Topical surfactant therapy has been found to be effective in the management of recalcitrant chronic rhinosinusitis. Objective: To determine in vitro the antibacterial potential of SinuSurf™, a previously commercially available sinonasal surfactant. Methods: Methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (PA) cultures were grown in the presence or absence of serial dilutions of mupirocin or gentamicin with and without SinuSurf and quantified by colony-forming units (CFUs). Biofilm formation was also assessed. Finally, bacterial growth was evaluated in sinus irrigation bottles inoculated with MRSA or PA and rinsed daily with SinuSurf. Results: SinuSurf alone evinced a 3-log (1,000-fold) and 6-log (10⁶-fold) reduction in CFUs for MRSA and PA, respectively. The combination of SinuSurf with a 1:10 dilution mupirocin and 1:100 dilution gentamicin demonstrated complete bacterial eradication. Similar concentrations of antibiotic dilutions alone demonstrated bacterial growth. SinuSurf averaged an 83% MRSA and 76% PA reduction in biofilm formation. Bottle contamination evaluation demonstrated reduction of MRSA and PA (p < 0.05) with SinuSurf. Conclusion: Biofilms have been demonstrated in chronic rhinosinusitis patients and implicated in recalcitrant disease. Our in vitro data demonstrates the addition of SinuSurf improved the effectiveness of a lower concentration of topical antibiotics in biofilm mass and viability.

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“…Still thorough discussions regarding potential side-effects of topical antibiotics should be discussed with any patients with the offlabel usage. Whatley et al [20] identified systemic absorption for topical gentamicin irrigations in patients who had previous functional endoscopic sinus surgery (FESS).…”

Section: Topical Antibioticsmentioning

confidence: 99%