Treatment of Acute Maxillary Sinusitis: II.<i>A Comparison of Five Further Methods</i>

Axelsson, A.; Chidekel, N.; Grebelius, N.; Jensen, C.; S, Särne

doi:10.3109/00016487109122467

Cited by 36 publications

(55 citation statements)

References 4 publications

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“…However, half of the patients who received the placebo felt recovered or much better after 10 days, and more than half of the patients who received antibiotics reported side effects. A third study 35 included 156 patients who were randomly assigned to receive nasal decongestants, nasal decongestants plus irrigation, penicillin, or lincomycin. At day 10, the rates of resolution or improvement did not differ significantly among the groups (72 percent, 80 percent, 83 percent, and 85 percent, respectively).…”

Section: Strategies and Evidencementioning

confidence: 99%

Acute Bacterial Sinusitis

Piccirillo

2004

N Engl J Med

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The new england journal of medicine n engl j med 351;9 www.nejm.org august 26, 2004 902 This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations.A 43-year-old man has a two-week history of nasal congestion, postnasal drip, and fatigue. He has used an over-the-counter nasal decongestant and acetaminophen, without relief. During the past few days, facial pain and pressure have developed and have not responded to decongestants. In addition, his nasal discharge has turned from clear to yellow. How should he be treated?Acute bacterial sinusitis is an infection of the paranasal sinuses with inflammation of the nose. On the basis of national population surveys and insurance-reimbursement claims, sinusitis is one of the most common health problems in the United States. 1 Acute bacterial sinusitis most commonly develops as a complication of a viral infection of the upper respiratory tract. Approximately 0.5 to 2 percent of cases of viral rhinosinusitis develop into bacterial infections. 2-4 Symptoms include nasal congestion, purulent nasal discharge, maxillary tooth discomfort, hyposmia or anosmia, cough, facial pain or pressure that is made worse by bending forward, headache, fever, and malaise. Physical findings include nasal turbinate edema, nasal crusts, purulence of the nasal cavity and posterior pharynx, and failure of transillumination of the maxillary sinuses. 5 Transillumination is performed in a completely darkened room by placing a flashlight against the skin overlying the infraorbital rim and directing the light inferiorly (Fig. 1). The patient then opens his or her mouth, and the hard palate is examined. The possible results are a palate that appears opaque or dull and a normal palate. However, the value of this procedure is limited; since it is not easy to perform, the clinician cannot differentiate viral from bacterial sinusitis, and results vary depending on the skill of the clinician. A particularly challenging task is to distinguish viral from bacterial sinusitis. In most patients, rhinoviral illness improves in 7 to 10 days 6 ; therefore, a diagnosis of acute bacterial sinusitis requires the persistence of symptoms for longer than 10 days or a worsening of symptoms after 5 to 7 days. Symptoms of viral sinusitis, including fever, mimic those of bacterial sinusitis, although the color and quality of nasal discharge -classically, clear and thin during viral sinusitis and yellow-green and thick during bacterial sinusitis -may help to differentiate the two.Studies over the past two decades have indicated that Streptococcus pneumoniae and Haemophilus influenzae are the major bacterial pathogens in adults with sinusitis. 7 Other species (including b -hemolytic and a -hemolytic streptococci, Staphylococcus aureus, and anaerobes) have also been cultured from adults with sinusitis but are much less frequ...

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Section: Strategies and Evidencementioning

confidence: 99%

Acute Bacterial Sinusitis

Piccirillo

2004

N Engl J Med

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“…Only two placebo controlled, randomised studies with clinical findings and objective visualisation as inclusion criteria have been found in the literature, one in children5 and one in adults 6. The last study has met with criticism 7…”

Section: Introductionmentioning

confidence: 99%

Randomised, double blind, placebo controlled trial of penicillin V and amoxycillin in treatment of acute sinus infections in adults

Lindbæk

Hjortdahl

Johnsen

1996

BMJ

134

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“…The advantage of tetra cyclines to penicillin in the treatment of sinus disease has also been con firmed by previous investigations demonstrating an increased penetration of tetracyclines into sinus secretion [Lundberg et al, 1968;G ullers et al, 1969] when compared to penicillin and of a low frequency of side effects [Axelsson et al, 1971], The above findings demonstrate the im portance of bacteriological and sensitivity studies of the treatment of a clinical entity such as acute maxillary sinusitis.…”

Section: Discussionmentioning

confidence: 54%

“…The present material comprises 243 specimens of sinus secretion from 171 untreated patients with acute maxillary sinusitis. Patients were subjected to different methods of treatment, and these results are published elsewhere [Axelsson et al, 1970b;1971].…”

Section: Methodsmentioning

confidence: 99%

Bacteriological Findings in Acute Maxillary Sinusitis

Axelsson¹,

Brorson²

1972

ORL

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A study was made of the bacteriology of acute maxillary sinusitis, diagnosis being made on the basis of clinical and radiological examinations. Material for study was taken only from maxillary sinuses with secretion, and consisted of 243 secretion specimens from 171 untreated patients. Bacteriological findings were in good agremeent with other recent studies. Most specimens yielded Diplococcuspneumoniae or Haemophilusinfluenzae or no growth. The findings were analyzed with regard to age and seasonal distribution. Staphyiococcusaureus, which is sometimes taken to indicate the degree of nasal contamination, was present in 10% of cultures. Decreased sensitivity to penicillin was found in 24% of all bacteria isolated, and to tetracycline in 3.5%. Stress is placed on the need for an accurate definition of this condition. The suitability of penicillin for the treatment of acute maxillary sinusitis is questioned.

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Treatment of Acute Maxillary Sinusitis: II.A Comparison of Five Further Methods

Cited by 36 publications

References 4 publications

Acute Bacterial Sinusitis

Acute Bacterial Sinusitis

Randomised, double blind, placebo controlled trial of penicillin V and amoxycillin in treatment of acute sinus infections in adults

Bacteriological Findings in Acute Maxillary Sinusitis

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