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Single-use device endoscopy for the diagnosis of acute bacterial rhinosinusitis in primary care: A pilot and
Dominik Glinz1,2, Jens Georg Hansen3, Caroline Trutmann4
1Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University Hospital Basel, Basel, Switzerland.
Objective:
Antibiotics are largely overprescribed for acute rhinosinusitis in primary care, mainly due to the lack of diagnostic tests to confirm or rule out bacterial infection. The study objective was to assess the on-site applicability and safety of the newly developed JGG endoscope® for the diagnosis of acute bacterial rhinosinusitis in primary care.
Design:
Five Swiss primary care centres and one university-affiliated ENT unit participated in this single-arm pilot study.
Participants:
Adults with acute suspected bacterial rhinosinusitis. The newly developed JGG endoscope® , which is attached to a pocket otoscope, was used to inspect after local anaesthesia the nasal cavity and middle meatus and to gain material for bacterial culture from paranasal sinuses draining ostium.
Main Outcome Measures:
Applicability and safety.
Results:
The visualisation of the middle meatus was successful in 16 of 21 patients (13 in both sides and three in one side), and unclear or unsuccessful in five patients. Sample collection from the middle meatus was successful in 10 patients (six on both and four on one side) and unclear or unsuccessful in the remaining patients. Only one culture-confirmed bacterial rhinosinusitis and 11 PCR-confirmed viral infections were identified from collected samples. After a 2-week follow-up, no serious adverse events were observed.
Conclusions:
The on-site use of the JGG endoscope® in daily primary care routine is feasible and safe and was well accepted by the trial physicians and patients (assessed with structured questionnaires). The JGG endoscope® may support general practitioners to differentiate between bacterial and viral rhinosinusitis.
Insights
A new JGG endoscope is safe and feasible for diagnosing acute bacterial rhinosinusitis in primary care. This tool may help general practitioners distinguish between bacterial and viral infections, reducing antibiotic overuse.
Area of Science:
- Otolaryngology
- Primary Care Medicine
- Infectious Disease Diagnostics
Background:
- Antibiotic overuse for acute rhinosinusitis in primary care is common due to diagnostic challenges.
- Differentiating bacterial from viral infections is crucial for appropriate treatment and antibiotic stewardship.
Purpose of the Study:
- To evaluate the on-site applicability and safety of the novel JGG endoscope for diagnosing acute bacterial rhinosinusitis in primary care settings.
- To assess the potential of the JGG endoscope to aid general practitioners in clinical decision-making.
Main Methods:
- A single-arm pilot study conducted in five Swiss primary care centers and one university ENT unit.
- Adult patients with suspected acute bacterial rhinosinusitis were enrolled.
- The JGG endoscope, attached to a pocket otoscope, was used for nasal cavity and middle meatus inspection and sample collection for bacterial culture after local anesthesia.
Main Results:
- Middle meatus visualization was successful in 16 of 21 patients.
- Sample collection from the middle meatus was successful in 10 patients.
- Only one culture-confirmed bacterial rhinosinusitis case was identified; 11 viral infections were confirmed by PCR. No serious adverse events were reported during the 2-week follow-up.
Conclusions:
- The JGG endoscope is feasible, safe, and well-accepted for use in daily primary care routines.
- The device shows potential to assist general practitioners in differentiating bacterial from viral rhinosinusitis.
- Improved diagnostics could lead to more targeted antibiotic prescribing and better patient outcomes.
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