Aspects of the treatment of maxillary sinusitis

The elimination of bacteria from sinus secretion during antibiotic treatment and the biological environment in the sinus as regards pO2 and pCO2 of sinus secretions were studied. Elimination of bacteria was achieved only, but not invariably, when the antibiotic concentration in the secretion greatly exceeded the MIC values of the bacteria isolated. Bacteriostatic and bactericidal antibiotics were equally effective. In purulent secretions as opposed to nonpurulent secretions the pO2 was always zero or close to zero, and the pCO2 was always higher than, and sometimes more than twice as high as the pCO2 of venous blood. In view of these observations, antibiotic therapy resulting in a high antibiotic concentration in the secretion is advocated in the treatment of purulent maxillary sinusitis. Furthermore, drainage and aeration of the sinus cavity is to be regarded as an important complement to the antibiotic therapy.