Are multiple sinus cultures necessary during sinus surgery for chronic rhinosinusitis?

Area of Science:

• Otolaryngology
• Infectious Disease
• Health Economics

Background:

• Multiple cultures are frequently collected during endoscopic sinus surgery (ESS) when purulence is present.
• The necessity and utility of obtaining multiple cultures are questioned.
• This practice may be redundant and increase healthcare costs.

Purpose of the Study:

• To evaluate if multiple sinus cultures provide additional information on pathogens.
• To determine if obtaining multiple cultures is a redundant, cost-increasing practice.
• To assess the utility of multiple sinus cultures from patient care and health economics perspectives.

Main Methods:

• Retrospective review of a single rhinologist's surgical database (2008-2016).
• Inclusion of patients undergoing ESS for chronic rhinosinusitis (CRS) with multiple cultures obtained.
• Recording discrepancies in infectious pathogens between cultures.

Main Results:

• 39.4% of 231 patients showed pathogen differences between cultures.
• Only 5% of patients benefited clinically from a second culture for antibiotic adjustment.
• The majority of multiple cultures did not yield clinically significant additional information.

Conclusions:

• Limiting intraoperative sinus cultures to a single sample is cost-effective and sufficient for pathogen identification.
• This approach can reduce healthcare costs for patients with CRS.
• A single intraoperative culture adequately guides treatment decisions.