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Systemic acute rhinosinusitis therapy consists mostly of antibiotic treatment because pathogens play a major role. Amoxicillin is the drug of choice for treatment of acute rhinosinusitis, with second- and third- generation cephalosporins, azythromycin, clarithromycin, and telithromycin as possible options, especially in the case of allergy to amoxicillin. If the clinical course suggests that an anaerobic pathogen is more likely, clindamycin or metronidazole can be considered in combination with a broad-spectrum drug. In antimicrobial treatment of chronic sinusitis there is no consensus on treatment length, organism coverage, or which antibiotics are most effective because the bacteriology is variable with polymicrobial anaerobic and aerobic organisms present. Adjuvant therapies need to be proven by additional studies. Chronic rhinosinusitis is heterogeneous and treatment should vary according to the causative factor involved. Short courses of systemic steroids have been found very useful to decrease mucosal swelling and inflammation in chronic rhinosinusitis. However, no randomized controlled studies have been performed to validate their efficacy in children. A variety of other agents are used in the treatment of chronic rhinosinusitis including antihistamines, decongestants, and leukotriene modifiers. To date, there is no good evidence from randomized controlled studies to support the use of any of these agents in the treatment of this disease in either children or adults.
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http://dx.doi.org/10.1111/j.1399-3038.2007.00636.x | DOI Listing |
Biochem Genet
March 2025
Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, Hubei, China.
Chronic rhinosinusitis (CRS) and depression are both common conditions with significant socioeconomic impact. The high co-occurrence of depression in CRS patients suggests a common pathophysiology, but the mechanisms are unclear. This study aimed to identify potential molecular links between the two conditions.
View Article and Find Full Text PDFInt Forum Allergy Rhinol
March 2025
Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown, West Virginia, USA.
Clin Immunol
March 2025
Department of Otorhinolaryngology, Yongchuan Chinese Medicine Hospital Affiliated to Chongqing Medical University, Chongqing 400000, People's Republic of China. Electronic address:
This study aimed to explore the molecular characteristics of neutrophil extracellular traps (NETs) in chronic rhinosinusitis with nasal polyps (CRSwNP). Differentially expressed gene analysis, weighted gene co-expression network analysis, and machine learning algorithms identified three core NETs-associated genes: CXCR4, CYBB, and PTAFR, which were significantly upregulated in CRSwNP patients. The diagnostic performance of these genes was evaluated using receiver operating characteristic (ROC) curves, and their clinical relevance was validated using multicenter data.
View Article and Find Full Text PDFHead Neck Pathol
March 2025
Department of Pathology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA.
Sinus content specimens from patients with chronic rhinosinusitis (CRS) are commonly encountered by surgical pathologists across various practice settings. The inflammatory cellular component of CRS often includes eosinophil-rich inflammation, and the specimens frequently contain polyps. Moreover, noninvasive forms of fungal rhinosinusitis can also be identified in the sinus contents of patients with CRS.
View Article and Find Full Text PDFInt Forum Allergy Rhinol
March 2025
Department of Head and Neck Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA.
Background: Residential proximity to commercial pesticide application has been associated with increased odds of developing chronic rhinosinusitis (CRS) with in vitro studies demonstrating cytotoxic dose-dependent effects on sinonasal epithelia. This study's aim is to determine potential associations between residential proximity to commercial pesticide application sites and cytokine profiles in patients with and without CRS.
Methods: A total of 55 patients were included (35 CRS and 20 control) with an average age of 55 ± 15 years.
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