Patients with chronic rhinosinusitis do not necessarily develop resistance to antibiotics

Patients with chronic rhinosinusitis (CRS, inflammation of the nasal passages and sinuses) do not necessarily develop resistance to antibiotics although they may be treated for long periods of time with these drugs, according to an article in the October issue of The Archives of Otolaryngology – Head & Neck Surgery, one of the JAMA/Archives journals.

According to the article, although the cause of CRS is controversial, most investigators agree that at least one of the main culprits is bacterial infection. Guidelines recommend extended courses of antibiotics as a first-line treatment for CRS before surgery is considered, the article states.

Neil Bhattacharyya, M.D., and Lynn J. Kepnes, R.N.P. of Brigham and Women’s Hospital, Boston, investigated whether patients with CRS develop an increasing prevalence of antibiotic resistance over time.

Over a seven-year period, the researchers studied data on microbiological sinus culture results (224 culture results, average 2.5 cultures per patient) from 90 adult patients with CRS. The average time between cultures for patients was 157 days, and 429 organisms were isolated from the cultures. Patterns of antimicrobial resistance were identified.

The researchers found, “No statistically significant increase in severity of antimicrobial resistance was demonstrated within patients as serial cultures were drawn,” the authors write. “In fact, a general trend toward decreasing antimicrobial resistance was noted overall, with many patients showing reversion to lesser degrees of antimicrobial resistance over time.”

The authors attributed the lack of developing resistance to very specific use of antibiotics most often guided by culture results to confirm the type of bacteria and the need for antibiotics.

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