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OTORINOLARINGOLOGIA

A Journal on Otorhinolaryngology, Head and Neck Surgery,
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Otorinolaringologia 2003 September;53(3):99-107

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Rhinosinusitis: new treatment strategies

Bergogne-Bérézin E.

Laboratory of Microbiology CHU Bichat-Claude Bernard, Paris, France


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Acute rhin­o­sin­u­sitis is one of the ­most com­mon caus­es of ­acute and chron­ic infec­tions ­seen in the com­mu­nity. The ­initial ­viral infec­tion can be fol­lowed by a bac­te­ri­al super­in­fec­tion ­which can be dem­on­strat­ed ­using spe­cif­ic inves­ti­ga­tions ­such as bac­te­ri­al iso­la­tion. In the ­great major­ity of cas­es the diag­no­sis is pre­sump­tive. Symptomatic treat­ments ­tend to ­reduce ­pain and inflam­ma­tion for easi­er pus drain­age. The deci­sion for anti­bi­o­tic ther­a­py con­tin­ues to be a mat­ter of ­debate. Many anti­bi­o­tics ­have ­been ­used, but mod­ern guide­lines ­have estab­lished rec­om­men­da­tions for the ­choice and dura­tion of treat­ments, ­based on: 1) epi­dem­i­olog­i­cal ­data on patho­gens and ­their resis­tance pro­file; 2) ­improved under­stand­ing of phar­ma­col­o­gy of anti­bi­o­tics, guid­ing dos­es and admin­is­tra­tion ­routes; 3) com­par­a­tive dou­ble ­blind stud­ies, eval­u­at­ing anti­bi­o­tics vs pla­ce­bo, β-lac­tams vs mac­ro­lides. Use of new­er ­drugs (flu­o­ro­qui­no­lones, ket­o­lides) ­must be dis­cussed in ­terms of ­cost/effi­ca­cy.

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