Clindamycin and chronic sinusitis
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Cochrane Database Syst Rev. Some studies have demonstrated some effect on reducing sinonasal symptoms and nasal polyps Ponikau and coworkers 59 hypothesized that fungal colonization is an important stimulus for persistent inflammation in patients with CRS, including those with or without nasal polyps.
J Chemother ; Every pharmacist told me that this drug is VERY potent so it was just a side effect, and nothing more serious. The purpose of surgical drainage is to enhance mucociliary flow and provide material for culture and sensitivity. The combination of careful surgical intervention FESS and postoperative medical therapy can have profound long-term benefits on both CRS and asthma, with significant long-term reductions in medical therapy.
Initial selection of the appropriate antibiotic therapy see Table 1, below should be based on the likely causative organisms given the clinical scenario and the probability of resistant strains within a community. In adults, sinus puncture can usually be achieved using local anesthesia; however, in children, a general anesthetic is usually necessary. Infection can spread directly through the thin bone separating the ethmoid or frontal sinuses from the orbit or by thrombophlebitis of the ethmoid veins.
Hnatuk comments on the aggressive nature of the disease and concludes that nonoperative medical management is not indicated. Topical antimicrobials in the management of chronic rhinosinusitis: Nonpathogenic, environmental fungi induce activation and degranulation of human eosinophils.
Failure of previous antimicrobial therapy. The drainage of the sinus can be done through both medicine and through surgery.
The efficacy of hypertonic saline nasal irrigation for chronic sinonasal symptoms. Do not prescribe topical or systemic antifungal therapy in patients with CRS. Based on a literature review, Kaper et al concluded that no studies have adequately addressed whether the effects of antibiotic therapy in recurrent acute rhinosinusitis differ from those in primary or sporadic episodes of acute rhinosinusitis. Ear, nose, and throat specialist for complications or when routine management techniques fail.
Similarly, a multicenter high-dose double-blind study of terbinafine Lamisil in the treatment of CRS performed by Kennedy and colleagues 64 failed to demonstrate any significant benefit either in terms of symptomatic or radiographic resolution.
Meticulous surgical dissection using mucosa-sparing techniques has allowed surgeons to treat sinus disease while preserving the natural function of the sinus mucosa.
What are antibiotics?
Int J Pediatr Otorhinolaryngol. Clindamycin Rating Summary 7. Talbot and colleagues 26 showed that buffered hypertonic saline nasal irrigation improved mucociliary clearance, whereas buffered physiological saline had no effect on mucociliary clearance.
The diagnosis and management of sinusitis: Otolaryngol Head Neck Surg. Joint Accredited with multiple accreditations, including:.
These agents are alpha-adrenergic agonists that act by constricting dilated mucosal vessels. In a pilot study involving 18 patients over 8 weeks, the addition of budesonide suspension to twice-daily nasal saline irrigations provided significant improvements in sinus symptoms, including the sense of smell