Antimicrobial therapy in complicated rhinosinusitis.

Area of Science:

• Otolaryngology
• Infectious Diseases
• Ophthalmology

Background:

• Complicated rhinosinusitis is a rare but severe condition with potential for orbital invasion and vision loss.
• Early medical and surgical intervention is critical for managing this life-threatening pathology.
• Orbital complications include diplopia, preseptal and orbital cellulitis, and blindness.

Purpose of the Study:

• To review a cohort of patients with complicated rhinosinusitis.
• To identify the microbial etiology of these extensive sinus infections.
• To analyze treatment strategies and outcomes, including antibiotic use and hospitalization duration.

Main Methods:

• Retrospective review of 32 patients diagnosed with complicated rhinosinusitis between 2015 and 2022.
• Analysis of demographic and medical data, including intravenous antibiotic and antifungal treatments.
• Microbial examination of nasal washouts or swabs obtained during endoscopic or combined approach surgery.

Main Results:

• The patient cohort was predominantly male (78%) with a mean age of 50.55 years.
• A variety of antibiotics were administered; antifungal drugs were used for mucormycosis cases.
• Mean hospitalization was 12 days, with correlations drawn between antibiotic type, orbital involvement, microbial strains, and outcomes.

Conclusions:

• Management of complicated rhinosinusitis is complex, requiring a multidisciplinary approach involving infectious disease specialists, ophthalmologists, and rhinologists.
• Identifying and treating multi-resistant or combined microbial strains presents significant challenges.
• Tailored, individualized treatment plans are essential for optimal patient outcomes.