Topical antibiotic therapy in chronic rhinosinusitis: an update

Area of Science:

• Otolaryngology
• Infectious Diseases
• Pharmacology

Background:

• Topical antibiotic therapies for chronic rhinosinusitis (CRS) have been debated.
• Existing guidelines and reviews recommend against their use based on prior randomized controlled trials (RCTs).

Purpose of the Study:

• To review recent clinical research on topical antibiotic therapies for CRS published after current guidelines were established.

Main Methods:

• A structured literature review was conducted.
• Included clinical studies published within the last 5 years.

Main Results:

• One double-blinded RCT supported tobramycin via vibrating aerosolizer.
• A prospective trial supported topical ofloxacin for anti-biofilm properties.
• A meta-analysis found short-term benefits with mupirocin irrigations.
• Systematic reviews indicated limited evidence, except possibly mupirocin for Staphylococcus aureus.
• Retrospective studies showed topical antibiotics alter sinus bacterial cultures.

Conclusions:

• Emerging evidence supports continued investigation of topical antibiotic therapies for CRS.
• Larger RCTs are necessary to definitively establish efficacy.