[Penetration behavior of mezlocillin in chronic polypous inflamed mucosa of the paranasal sinuses].

Recent investigations have shown that conservative treatment of chronic sinusitis, especially with polypi in the nasal cavity and in the paranasal sinuses, is not as successful as in acute inflammation. Surgical intervention to remove the diseased mucosa is necessary. The newly developed more conservative endonasal techniques may nevertheless allow spread of the pathogenic bacteria during surgery. Mezlocillin has a broad spectrum against both aerobic and anaerobic micro-organisms: its penetration into the hyperplastic mucosa of the chronically diseased maxillary sinus was therefore investigated. In 15 patients with chronic sinusitis a 5 g bolus injection of mezlocillin was given half an hour before the operation. Two more doses of the antibiotic were given 6 and 12 h afterwards. The specimens investigated were blood taken before the injection of mezlocillin, and blood and tissue taken by the endoscopic endonasal techniques innovated by Wigand (1977) between 30 and 120 min after the start of the operation. The concentration of mezlocillin was determined by bioassay using Bacillus subtilis ATCC 6633 as indicator organisms. The results were compared with the minimal inhibitory concentration of bacteria usually found in chronic maxillary sinusitis. The results showed that mezlocillin may be of value in chronic paranasal infections in the conservative treatment of complications of sinus infections, especially if surgery is contraindicated because the patient is a high anaesthetic risk.