Introduction: Rhinosinusitis (RS) is defined as acute when it lasts up to 4 weeks and chronic when it lasts at least 12 weeks. Most acute forms begin with a viral upper respiratory infection that spreads into the paranasal sinuses and is followed by bacterial infection. It is uncertain how bacteria affect chronic rhinosinusitis (CRS). Area covered: We review the current treatment of bacterial rhinosinusitis in adults, referring mainly to the two key documents published by the European Position Paper on Rhinosinusitis and Nasal Polyps 2020 and the International Consensus Statement 2021 on Allergy and Rhinology: Rhinosinusitis. Expert opinion: The routine use of antibiotics should be avoided because most acute RS (ARS) have a viral origin. In patients with persistent/worsening symptoms, the most appropriate empirical therapy is a course of amoxicillin (with or without clavulanate). Macrolides are considered therapy options for CRS mainly because of their anti-inflammatory activity. The best agent, dose, and treatment duration still need to be identified due to a lack of solid evidence. Inflammation and symptoms must also be reduced, mainly by using nasal corticosteroids. Since antibiotic use in bacterial rhinosinusitis is questionable, the research focuses on non-antibiotic antimicrobial treatments.

Matera, M.g., Rinaldi, B., de Novellis, V., Rogliani, P., Cazzola, M. (2022). Current and emerging treatment modalities for bacterial rhinosinusitis in adults: a comprehensive review. EXPERT OPINION ON PHARMACOTHERAPY, 23(18), 2013-2022 [10.1080/14656566.2022.2147825].

Current and emerging treatment modalities for bacterial rhinosinusitis in adults: a comprehensive review

Rogliani, Paola;Cazzola, Mario
2022-12-01

Abstract

Introduction: Rhinosinusitis (RS) is defined as acute when it lasts up to 4 weeks and chronic when it lasts at least 12 weeks. Most acute forms begin with a viral upper respiratory infection that spreads into the paranasal sinuses and is followed by bacterial infection. It is uncertain how bacteria affect chronic rhinosinusitis (CRS). Area covered: We review the current treatment of bacterial rhinosinusitis in adults, referring mainly to the two key documents published by the European Position Paper on Rhinosinusitis and Nasal Polyps 2020 and the International Consensus Statement 2021 on Allergy and Rhinology: Rhinosinusitis. Expert opinion: The routine use of antibiotics should be avoided because most acute RS (ARS) have a viral origin. In patients with persistent/worsening symptoms, the most appropriate empirical therapy is a course of amoxicillin (with or without clavulanate). Macrolides are considered therapy options for CRS mainly because of their anti-inflammatory activity. The best agent, dose, and treatment duration still need to be identified due to a lack of solid evidence. Inflammation and symptoms must also be reduced, mainly by using nasal corticosteroids. Since antibiotic use in bacterial rhinosinusitis is questionable, the research focuses on non-antibiotic antimicrobial treatments.
dic-2022
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/10 - MALATTIE DELL'APPARATO RESPIRATORIO
English
Con Impact Factor ISI
Acute bacterial rhinosinusitis
Nasal Polyps
antibiotics
bacteriophages
chronic rhinosinusitis
corticosteroids
nonantibiotic antimicrobial therapies
probiotics
Matera, M.g., Rinaldi, B., de Novellis, V., Rogliani, P., Cazzola, M. (2022). Current and emerging treatment modalities for bacterial rhinosinusitis in adults: a comprehensive review. EXPERT OPINION ON PHARMACOTHERAPY, 23(18), 2013-2022 [10.1080/14656566.2022.2147825].
Matera, Mg; Rinaldi, B; de Novellis, V; Rogliani, P; Cazzola, M
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/329637
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