Etiology and antimicrobial therapy of acute maxillary sinusitis.
Eighty-one adults with symptoms of acute sinusitis were studied by direct needle puncture and aspiration of the maxillary sinus (105 sinuses). Fifty-nine bacterial strains were isolated in titers of greater than or equal to 10(4) colony-forming units/ml; Streptococcus pneumoniae and Haemophilus influenzae accounted for 64% of the isolates. Other bacteria recovered included anaerobes (12%), Neisseria species (8.5%). Streptococcus pyogenes (3%), alpha-hemolytic Streptococcus (3%), non-group A beta-hemolytic Streptococcus (3%), Staphylococcus aureus (2%), Pseudomonas aeruginosa (2%), and Escherichia coli (2%). Viruses were isolated from 11 sinuses; these isolates included rhinovirus (six), influenza A (H3N2) virus (three), and two types of parainfluenza virus (one each). The efficacy of therapy with orally administered ampicillin, amoxicillin, or trimethoprim-sulfamethoxazole was evaluated by a repeat sinus puncture and culture. Clinical and bacteriologic responses to all three regimens were good.
D000328:Adult; D000658:Amoxicillin / Q000627:therapeutic use; D000667:Ampicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001419:Bacteria / Q000302:isolation & purification; D006192:Haemophilus Infections / Q000382:microbiology*; D006193:Haemophilus influenzae / Q000302:isolation & purification; D006801:Humans; D008443:Maxillary Sinus / Q000382:microbiology; D012852:Sinusitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D013290:Streptococcal Infections / Q000382:microbiology*; D013296:Streptococcus pneumoniae / Q000302:isolation & purification; D013420:Sulfamethoxazole / Q000627:therapeutic use; D014295:Trimethoprim / Q000627:therapeutic use; D014780:Viruses / Q000302:isolation & purification
D000900:Anti-Bacterial Agents; D000667:Ampicillin; D000658:Amoxicillin; D014295:Trimethoprim; D013420:Sulfamethoxazole