Nebulized Antibiotics Helpful in Chronic Sinusitis

Laurie Barclay, MD

Jan. 7, 2003. Chronic sinusitis can be difficult to treat, especially after sinus operations. Results of a pilot study reported in the December issue of Otolaryngology, Head and Neck Surgery suggest that nebulized culture-specific antibiotics offered long-term suppression of symptoms and infection.

"These results are very encouraging," lead author Winston Vaughan, MD, from the Stanford Sinus Center in Palo Alto, California, says in a news release. Nebulized antibiotics "may serve as a new treatment option in an often frustrating disease process."

In this 12-month study beginning in November 2000, 42 patients with chronic sinusitis, previous sinus surgery, and an acute infection were offered nebulized antibiotics or standard therapy. Endoscopy and review of symptoms before and after nebulized therapy revealed that patients receiving nebulized antibiotics were free of infection for 17 weeks on average, compared with six weeks for standard therapy.

Posterior nasal discharge, facial pain and pressure, and emotional symptoms improved significantly in 76% of patients receiving nebulized antibiotics. The most common adverse events were sore throat and cough.

Dr. Vaughan and colleagues suggest that nebulized antibiotics offer a promising treatment option for recalcitrant sinus infections persisting even after surgery in patients who have failed, or who cannot tolerate, oral or intravenous antibiotics.

Although more research is needed to determine the mechanism of action, "the common-sense answer is, we're getting more of the medication directly to the tissues that need it," says Dr. Vaughan, chair of the scientific advisory board of SinusPharmacy Corp., which provided medications for this study.

Otolaryngol Head Neck Surg. 2002;127:558-568

Reviewed by Gary D. Vogin, MD

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