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Antibiotic Treatment (Topical/Systemic)

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Nasal Polyposis

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Abstract

The role of bacteria in the pathogenesis of chronic rhinosinusitis (CRS) with and without nasal polyps is still controversial. Contrary to acute rhinosinusitis, CRS often exhibits polymicrobial infections with Gram-positive, Gram-negative, and anaerobic bacteria present. Bacterial biofilms, intracellular residency, and exotoxins potentially contribute to the inflammatory processes of CRS. Macrolide antibiotics have anti-inflammatory, immunomodulatory, antimucus, and antibacterial actions. There is no clear evidence for topical intranasal antibiotic agents in the treatment of CRS. Several antiseptic solutions and saline nasal lavages are of increasing interest. There is no clear evidence for short-term systemic antibiotic agents in the treatment of CRS, but culture-directed short-course oral therapy should be considered on an individual basis. There is good evidence that long-term macrolide antibiotic treatment improves symptoms, decreases nasal polyp size, and reduces inflammatory markers in CRS. Further, associated bronchial asthma seems to improve in parallel by this treatment. It is important to be aware of the potential side effects of antibiotic agents.

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Authors and Affiliations

  1. Service d’Oto-rhino-laryngologie et de Chirurgie cervico-faciale, Hôpital de Sion, CHCVs – RSV, Avenue du Grand-Champsec 80, 1950, Sion, Switzerland

    Roland Giger

  2. Unité de Rhinologie – Olfactologie, Service d’Oto-rhino-laryngologie et de Chirurgie cervico-faciale, Hôpitaux Universitaires de Genève, Rue Micheli-du-Crest 24, 1211, Genève, Switzerland

    Basile N. Landis, Nicholas W. Stow & Jean-Silvain Lacroix

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  1. Roland Giger
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  2. Basile N. Landis
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  4. Jean-Silvain Lacroix
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Correspondence to Roland Giger .

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  1. Faculty of Medicine, Dept. of Otorhinolaryngology, Hacettepe University, Ankara, 06100, Turkey

    T. Metin Önerci

  2. School of Medicine, Dept. Otolaryngology, University of Pittsburgh, Locust Street 1400, Pittsburgh, 15219, USA

    Berrylin J. Ferguson

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Giger, R., Landis, B.N., Stow, N.W., Lacroix, JS. (2010). Antibiotic Treatment (Topical/Systemic). In: Önerci, T., Ferguson, B. (eds) Nasal Polyposis. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-11412-0_25

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