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General antibiotic exposure is associated with increased risk of developing chronic rhinosinusitis
Author(s) -
Maxfield Alice Z.,
Korkmaz Hakan,
Gregorio Luciano L.,
Busaba Nicolas Y.,
Gray Stacey T.,
Holbrook Eric H.,
Guo Rong,
Bleier Benjamin S.
Publication year - 2017
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.26232
Subject(s) - medicine , odds ratio , nasal polyps , antibiotics , confidence interval , sinusitis , chronic rhinosinusitis , microbiome , surgery , bioinformatics , microbiology and biotechnology , biology
Objective Antibiotic use and chronic rhinosinusitis (CRS) have been independently associated with microbiome diversity depletion and opportunistic infections. This study was undertaken to investigate whether antibiotic use may be an unrecognized risk factor for developing CRS. Study Design Case‐control study of 1,162 patients referred to a tertiary sinus center for a range of sinonasal disorders. Methods Patients diagnosed with CRS according to established consensus criteria (n = 410) were assigned to the case group (273 without nasal polyps [CRSsNP], 137 with nasal polyps [CRSwNP]). Patients with all other diagnoses (n = 752) were assigned to the control group. Chronic rhinosinusitis disease severity was determined using a validated quality of life (QOL) instrument. The class, diagnosis, and timing of previous nonsinusitis‐related antibiotic exposures were recorded. Results were validated using a randomized administrative data review of 452 (38.9%) of patient charts. The odds ratio of developing CRS following antibiotic exposure were calculated, as well as the impact of antibiotic use on the subsequent QOL. Results Antibiotic use significantly increased the odds of developing CRSsNP (odds ratio: 2.21, 95% confidence interval, 1.66–2.93, P < 0.0001) as compared to nonusers. Antibiotic exposure was significantly associated with worse CRS QOL scores ( P = 0.0009) over at least the subsequent 2 years. These findings were confirmed by the administrative data review. Conclusion Use of antibiotics more than doubles the odds of developing CRSsNP and is associated with a worse QOL for at least 2 years following exposure. These findings expose an unrecognized and concerning consequence of general antibiotic use. Level of Evidence 3b. Laryngoscope , 2016 127:296–302, 2017