Fluticasone propionate is associated with severe infection after endoscopic polypectomy.
OBJECTIVE
To test whether the use of fluticasone dipropionate nasal spray after endoscopic ethmoidectomy for multiple polyps is associated with a high incidence of infection. DESIGN. Randomized control study comparing the incidence of infection with the use of beclomethasone dipropionate or fluticasone propionate nasal spray after functional endoscopic sphenoethmoidectomy. Patients were followed up for 6 to 12 months.


METHODS
Sixty patients with recurrent bilateral nasal polyps underwent functional endoscopic sphenoethmoidectomy and were then randomly allocated into 2 groups of 30 patients each. One group received beclomethasone dipropionate spray (100 micrograms in each nostril every 12 hours), and the other group received fluticasone propionate spray (100 micrograms/d in each nostril).


RESULTS
In the fluticasone propionate group, 6 patients (20%) developed acute gram-positive pansinusitis requiring hospitalization and discontinuation of treatment.


CONCLUSIONS
The use of fluticasone dipropionate aqueous nasal spray for the postoperative control of recurrent nasal polyps seems to be associated with a high incidence of acute pansinusitis.
Mostafa
B E
BE
Department of Otorhinolaryngology, Ain-Shams University, Cairo, Egypt.
D000208:Acute Disease; D000328:Adult; D000336:Aerosols; D000730:Androstadienes / Q000008:administration & dosage / Q000009:adverse effects*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001507:Beclomethasone / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004724:Endoscopy; D005260:Female; D000068298:Fluticasone; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000150:complications / Q000188:drug therapy* / Q000601:surgery*; D011182:Postoperative Care / Q000009:adverse effects*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D012852:Sinusitis / Q000453:epidemiology / Q000209:etiology*
D000336:Aerosols; D000730:Androstadienes; D000893:Anti-Inflammatory Agents; D000068298:Fluticasone; D001507:Beclomethasone