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Topical antibiotic therapy in chronic rhinosinusitis: an update
Author(s) -
Carlton Daniel A.,
Beahm D. David,
Chiu Alexander G.
Publication year - 2019
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.22338
Subject(s) - medicine , randomized controlled trial , mupirocin , antibiotics , intensive care medicine , sinusitis , chronic rhinosinusitis , clinical trial , medline , surgery , methicillin resistant staphylococcus aureus , staphylococcus aureus , biology , bacteria , law , political science , microbiology and biotechnology , genetics
Background Topical antibiotic therapies have been investigated for their use in chronic rhinosinusitis (CRS). However, society guidelines and evidence‐based medicine reviews have recommended against the use of topical antibiotic therapy based on randomized controlled trials (RCTs). The purpose of this article is to review recent clinical research published since the aforementioned guidelines were published. Methods A structured literature review was performed on clinical studies published in the last 5 years investigating the use of topical antibiotic therapies. Results One double‐blinded, randomized controlled trial (DB‐RCT) supported the use of tobramycin using a vibrating aerosolizer; 1 non‐blinded non‐randomized controlled prospective trial lent support to use of topical ofloxacin for its anti‐biofilm properties; and 1 meta‐analysis found mupirocin irrigations to be beneficial in the short term. One Cochrane Review was unable to make a recommendation as no trial met the inclusion criteria. An additional systematic review found limited evidence to support the use of topical antibiotics with the exception of mupirocin irrigations that may be considered in Staphylococcus aureus infections. Two retrospective studies found that topical antibiotics change bacterial cultures of the sinuses. Conclusion There is additional evidence to support continuing investigation of topical antibiotic therapies. Further, larger RCTs are required to establish the efficacy of topical antibiotic therapies.