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The bacteriology of acute maxillary sinusitis
J Ylikoski1, S Savolainen, H Jousimies-Somer
1Central Military Hospital, Helsinki, Finland.
Summary
This study found Haemophilus influenzae to be the most common pathogen in acute maxillary sinusitis. Aminopenicillins may be a more effective treatment than penicillin for these infections.
Area of Science:
- Otolaryngology
- Microbiology
- Infectious Diseases
Background:
- Acute maxillary sinusitis is a common condition often treated with antibiotics.
- Bacteriological analysis of sinus secretions is crucial for identifying causative pathogens and guiding treatment.
Purpose of the Study:
- To bacteriologically examine sinus secretions from patients with acute maxillary sinusitis.
- To identify the prevalence of aerobic and anaerobic bacteria.
- To determine the most common pathogens and inform antimicrobial treatment strategies.
Main Methods:
- Sinus secretions were obtained via antral aspiration from 347 patients.
- 485 samples were analyzed for aerobic and anaerobic bacterial cultures.
- Special attention was given to anaerobic bacteria recovery methods.
Main Results:
- Bacterial cultures were negative in 24% of sinuses.
- Haemophilus influenzae (50.5%) was the most frequently isolated pathogen, followed by Streptococcus pneumoniae (18.5%).
- True anaerobic infections were rare (1.5%), suggesting anaerobes are not a significant cause.
Conclusions:
- Haemophilus influenzae is the predominant pathogen in acute maxillary sinusitis among young adults.
- Aminopenicillins may be a more appropriate first-line treatment than conventional penicillin.
- Targeted antimicrobial therapy based on identified pathogens improves treatment efficacy.