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Atrophic rhinitis: antibiotic treatment.

J P Dudley¹

¹Department of Surgery/Division of Head and Neck Surgery, UCLA School of Medicine 90024.

American Journal of Otolaryngology

|November 1, 1987

Summary

Atrophic rhinitis, a rare nasal infection, often involves Klebsiella ozenae. Topical aminoglycosides show promise for treating this condition, offering an effective and cost-efficient alternative.

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Area of Science:

Otolaryngology
Infectious Diseases
Microbiology

Background:

Atrophic rhinitis is a rare nasal condition characterized by bilateral nasal obstruction and persistent foul odor.
The primary causative agent is frequently Klebsiella ozenae, a microorganism with challenging antibiotic susceptibility patterns.
Oral antibiotic treatments have shown limited efficacy due to resistance issues.

Observation:

Klebsiella ozenae was identified in the nasal cavities of three patients diagnosed with atrophic rhinitis.
Two patients received intravenous tobramycin; one experienced odor reduction, while the other showed complete resolution of odor and bacterial presence.
A third patient initially treated with intravenous tobramycin showed partial improvement, necessitating further treatment.

Findings:

Intravenous tobramycin demonstrated variable success in eradicating Klebsiella ozenae and resolving symptoms.
Subsequent topical gentamicin treatment in the third patient led to the complete disappearance of both the foul odor and the bacteria.
The minimum inhibitory concentration (MIC) for tobramycin was 4 µg/ml, and for gentamicin, it was 0.5 µg/ml.

Implications:

Intravenous aminoglycoside therapy may be beneficial for treating atrophic rhinitis caused by Klebsiella ozenae.
Topical aminoglycoside application presents a potentially effective, more affordable treatment option for atrophic rhinitis.
Further research into topical antibiotic efficacy for rare nasal infections is warranted.

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