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Endoscopic sinus surgery reduces antibiotic utilization in rhinosinusitis
Author(s) -
Bhandarkar Naveen D.,
Mace Jess C.,
Smith Timothy L.
Publication year - 2011
Publication title -
international forum of allergy and rhinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.503
H-Index - 46
eISSN - 2042-6984
pISSN - 2042-6976
DOI - 10.1002/alr.20005
Subject(s) - medicine , antibiotics , sinusitis , prospective cohort study , chronic rhinosinusitis , antibiotic resistance , chronic sinusitis , cohort , surgery , microbiology and biotechnology , biology
Background Antibiotics are a mainstay of treatment for chronic rhinosinusitis (CRS) and recurrent acute rhinosinusitis (RARS). Although quality‐of‐life outcomes following endoscopic sinus surgery (ESS) have been studied, the change in antibiotic utilization following ESS is less well known. Objective We aimed to determine the effect of ESS on antibiotic utilization in CRS and RARS. Methods A multi‐institutional, prospective cohort of patients with CRS and RARS was enrolled between January 2001 and January 2009. Patients completed the medication subscale of the Chronic Sinusitis Survey (CSS), and the Wilcoxon signed‐rank test was used to compare differences in the overall reported time of antibiotic between preoperative and postoperative time points. Results A total of 503 patients were followed for an average 17.3 months. Overall, patients reported a 57.2% reduction in time on antibiotics following ESS. The majority of patients (60.4%) reported significantly less antibiotic utilization after ESS ( p < 0.001) consisting of an 83.7% reduction in the time on antibiotics. Subgroup analysis also revealed a significant reduction in antibiotic utilization for patients with and without nasal polyposis (59.0% and 58.2%; both p < 0.001) as well as RARS (61.2%; p = 0.001). Conclusion ESS significantly reduces antibiotic utilization for CRS and RARS. This finding demonstrates potential for lower health care expenditures related to antibiotics, as well as reduced risk of both antibiotic related morbidity and development of bacterial resistance. © 2011 ARS‐AAOA, LLC.