Treatment of Chronic Rhinosinusitis Refractory to Other Treatments with Topical Antibiotic Therapy Delivered by Means of a Large‐Particle Nebulizer: Results of a Controlled Trial

Abstract

Large-particle nebulized aerosol therapy may offer a safe and effective management alternative for patients with refractory rhinosinusitis.

The diagnosis and management of sinusitis: A practice parameter update

“…The microbiology of paranasal sinus infections can be anticipated according to the age of the patient, clinical presentation, and immunocompetency of the host. [25][26][27][28][29][30][31][32][33][34][35][36][37] In acute sinus disease viral upper respiratory tract infections frequently precede bacterial superinfection by S pneumoniae, H influenzae, and M catarrhalis. [25][26][27] Both M catarrhalis and H influenzae can produce b-lactamase and thereby be resistant to amoxicillin.…”

Culture-Directed Topical Antibiotic Treatment for Chronic Rhinosinusitis

“…5 The three randomized controlled trials compared topical antibiotic therapy to placebo and demonstrated no clinical benefit. [6][7][8] Although all the patients had had ESS, all three randomized controlled trials used delivery methods (intranasal spray or nebulizer) other than high-volume irrigation and were underpowered. [6][7][8] The systematic review identified 14 studies of heterogeneous study design that looked at both topical antibiotics and antifungals in CRS and concluded that topical antibiotic therapy may be beneficial.…”

Antimicrobial therapy in chronic rhinosinusitis

“…Desrosiers and Salas-Prato [24] and Kamijyo et al [25] demonstrated signifi cant symptomatic improvement with the use of topical antimicrobials. However, the former controlled trial failed to show any signifi cant difference between tobramycin and a control arm with saline nebulization alone in maintenance therapy.…”