Pérez BN, Morales CM

Language: Spanish
References: 9
Page: 1-4
PDF size: 457.30 Kb.

ABSTRACT

Objective: To determine the current bacteriology and microbiology resistance of patients with chronic rhinosinusitis. The goal is to offer an antimicrobial treatment based on the etiologic agent and antibiotic resistance.
Patients and method: Prospective observational study. 21 patients with diagnosis of chronic rhinosinusitis, with endoscopic and topographic diagnosis, without good outcome with maximal medical treatment were included. Patients were scheduled for endoscopic sinus surgery from October 2006 to February 2001, in the Otolaryngology Service of the Hospital Español de Mexico. The diagnosis was based on the criteria of the Mexican Consensus of Adult Chronic Rhinosinusitis. During surgery guided by 0° endoscope, we took three cultures using Transcult of the following areas: maxillary ostium, middle meatus, and superior meatus.
Results: From 21 patients, the results were: 8 (37%) Staphylococcus aureus, 7 (33.3%) negative cultures, 2 (9.5%) Moraxella catarrhalis, 2 (9.5%) Haemophilus influenzae, 1 (4.76%) Corynebacterium, 1 (4.76%) Streptococcus pneumoniae. 33% of the patients had negative cultures, literature reported 28%.
Conclusions: Based on our findings, we conclude that ofloxacin and clindamycin are the best choices of treatment in all cases. We also found that the main resistance is for ampicillin in 100% of the patients, therefore we don’t recommend it as a treatment option.

REFERENCES

1. Lanza DC, Kennedy DW. Adult rhinosinusitis defined. Otolaryngol Head Neck Surg 1997;117(3 Pt. 2):S1-S7.

2. Lund VJ, Kennedy DW. Quantification for staging sinusitis. The Staging and Therapy Group. Ann Otol Rhinol Laryngol Suppl 1995;167:17-21.

3. Benninger MS, Ferguson BJ, Hadley JA, Hamilos DL, et al. Adult chronic rhinosinusitis: definitions, diagnosis, epidemiology, and pathophysiology. Otolaryngol Head Neck Surg 2003;129(3 Suppl.):S1-S32.

4. Stankiewicz JA, Chow JM. Nasal endoscopy and the definition and diagnosis of rhinosinusitis. Otolaryngol Head Neck Surg 2002;126:623-627.

5. García Rodríguez JA, García Sánchez. Diagnóstico y tratamiento antimicrobiano de la sinusitis. Consenso. Rev Esp Quimioterap 2003;16(2):239-251.

6. Biel MA, Brown CA, Levinson RM, Garvis GE, et al. Evaluation of the microbiology of chronic maxillary sinusitis. Ann Otol Rhinol Laryngol 1998;107:(11 Pt. 1):942-945.

7. Infectious rhinosinusitis in adults: classification, etiology and management. International Rhinosinusitis Advisory Board. Ear Nose Throat J 1997;76(12 Suppl.):1-22.

8. Hsu J, Lanza DC, Kennedy DW. Antimicrobial resistance in bacterial chronic sinusitis. Am J Rhinol 1998;12:243-248.

9. Bhattacharyya N, Kepnes LJ. The microbiology of recurrent rhinosinusitis after endoscopic sinus surgery. Arch Otolaryngol Head Neck Surg 1999;125:1117-1120.