Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology · 2007
Radiographic resolution of chronic rhinosinusitis without polyposis after 6 weeks vs 3 weeks of oral antibiotics.
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Dubin Marc G, Kuhn Frederick A, Melroy Christopher T
Аннотация
BACKGROUND: Maximal medical therapy is poorly defined in chronic sinusitis treatment.
OBJECTIVE: To objectively evaluate the radiographic response of chronic rhinosinusitis without polyposis after 3 and 6 weeks of oral antibiotics.
METHODS: Thirty-five patients with confirmed chronic sinusitis without polyposis (disease apparent on initial computed tomography [CT] with appropriate symptom duration) were prescribed 6 weeks of antibiotics. When possible, culture-directed antibiotics were used; otherwise clindamycin was used empirically. A CT was performed after 3 and 6 weeks of therapy. CTs were then graded by the Lund-Mackay system. Demographic data were reviewed.
RESULTS: Of the 35 patients, 16 underwent all 3 CT scans and completed all 6 weeks of antibiotics. Three patients completed only 3 weeks of antibiotics, and 16 did not undergo the interval 3-week CT. Six patients (38%) had statistically significant improvement in their CT scans between weeks 3 and 6. In this subset of patients who improved, 37% of their overall radiographic improvement occurred in the 3- to 6-week treatment interval. No prognostic variables predicted which patients would radiographically improve after 3 weeks of antibiotics.
CONCLUSION: Some patients achieve radiographic improvement and disease resolution after the completion of a 3-week course of antibiotics. Therefore, maximal medical therapy for chronic sinusitis may consist of longer than 3 weeks of therapy to ensure maximal benefit.
OBJECTIVE: To objectively evaluate the radiographic response of chronic rhinosinusitis without polyposis after 3 and 6 weeks of oral antibiotics.
METHODS: Thirty-five patients with confirmed chronic sinusitis without polyposis (disease apparent on initial computed tomography [CT] with appropriate symptom duration) were prescribed 6 weeks of antibiotics. When possible, culture-directed antibiotics were used; otherwise clindamycin was used empirically. A CT was performed after 3 and 6 weeks of therapy. CTs were then graded by the Lund-Mackay system. Demographic data were reviewed.
RESULTS: Of the 35 patients, 16 underwent all 3 CT scans and completed all 6 weeks of antibiotics. Three patients completed only 3 weeks of antibiotics, and 16 did not undergo the interval 3-week CT. Six patients (38%) had statistically significant improvement in their CT scans between weeks 3 and 6. In this subset of patients who improved, 37% of their overall radiographic improvement occurred in the 3- to 6-week treatment interval. No prognostic variables predicted which patients would radiographically improve after 3 weeks of antibiotics.
CONCLUSION: Some patients achieve radiographic improvement and disease resolution after the completion of a 3-week course of antibiotics. Therefore, maximal medical therapy for chronic sinusitis may consist of longer than 3 weeks of therapy to ensure maximal benefit.