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Endoscopic sinus surgery reduces antibiotic utilization in rhinosinusitis.
Naveen D Bhandarkar1, Jess C Mace, Timothy L Smith
1Division of Rhinology and Sinus Surgery/Oregon Sinus Center, Department of Otolaryngology–Head and Neck Surgery, Oregon Health & Science University (OHSU), Portland, OR, USA.
International Forum of Allergy & Rhinology
|June 14, 2011
Summary
Endoscopic sinus surgery (ESS) significantly reduces antibiotic use in patients with chronic rhinosinusitis (CRS) and recurrent acute rhinosinusitis (RARS). This leads to fewer antibiotic-related side effects and lower healthcare costs.
Area of Science:
- Otolaryngology
- Medical treatment outcomes
- Surgical intervention impact
Background:
- Antibiotics are standard treatment for chronic rhinosinusitis (CRS) and recurrent acute rhinosinusitis (RARS).
- Quality of life after endoscopic sinus surgery (ESS) is studied, but antibiotic use changes are less understood.
Purpose of the Study:
- To evaluate the impact of ESS on antibiotic consumption in patients with CRS and RARS.
Main Methods:
- A prospective, multi-institutional study enrolled patients with CRS and RARS from 2001-2009.
- Patients completed the Chronic Sinusitis Survey (CSS) medication subscale.
- The Wilcoxon signed-rank test compared antibiotic use pre- and post-surgery.
Main Results:
- 503 patients were followed for an average of 17.3 months.
- Overall antibiotic use decreased by 57.2% post-ESS.
- 60.4% of patients had significantly reduced antibiotic use (83.7% reduction).
- Significant reductions were observed in patients with/without nasal polyposis and those with RARS.
Conclusions:
- Endoscopic sinus surgery (ESS) substantially lowers antibiotic utilization in CRS and RARS.
- This reduction may decrease healthcare expenses and mitigate risks of antibiotic-related morbidity and bacterial resistance.
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