Current management of acute bacterial rhinosinusitis and the role of moxifloxacin.
Episodes of acute rhinosinusitis are common among adults and are associated with a significant amount of morbidity. The symptoms of rhinosinusitis are nasal drainage, congestion, and sinus pressure. A bacterial sinus infection is more likely if these symptoms worsen after 5-7 days or do not improve after 10-14 days. The majority of bacterial episodes have been associated with Streptococcus pneumoniae and Haemophilus influenzae. In the current era of increasing resistance to beta -lactams and macrolides, treatment guidelines have been formulated worldwide to assist clinicians in the selection of antibacterials. According to one model, the following antibacterials are most likely to provide desired outcomes (90%-92% predicted clinical efficacy) for adults: respiratory fluoroquinolones (i.e., moxifloxacin, gatifloxacin, and levofloxacin), ceftriaxone, and high-dose amoxicillin-clavulanate (4 g of amoxicillin/day and 250 mg of clavulanate/day). Although the role of the fluoroquinolones in the treatment of this condition is evolving, fluoroquinolones are often recommended as second-line therapy or as first-line therapy for selected patients (e.g., those who received antibacterials in the previous 4-6 weeks or adults with moderate-to-severe disease).
Anon
Jack B
JB
Department of Otolaryngology, University of Pittsburgh School of Medicine, Erie, Pennsylvania 16508, USA. janonmd@velocity.net
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001372:Aza Compounds / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D002986:Clinical Trials as Topic; D004352:Drug Resistance, Microbial; D024841:Fluoroquinolones / Q000494:pharmacology / Q000627:therapeutic use; D000077734:Gatifloxacin; D006193:Haemophilus influenzae / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D064704:Levofloxacin; D015201:Meta-Analysis as Topic; D000077266:Moxifloxacin; D015242:Ofloxacin / Q000627:therapeutic use; D017410:Practice Guidelines as Topic / Q000592:standards; D011804:Quinolines / Q000627:therapeutic use*; D012220:Rhinitis / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology / Q000503:physiopathology; D012852:Sinusitis / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology / Q000503:physiopathology; D013296:Streptococcus pneumoniae / Q000187:drug effects / Q000302:isolation & purification
D000900:Anti-Bacterial Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; D064704:Levofloxacin; D015242:Ofloxacin; D000077734:Gatifloxacin; D000077266:Moxifloxacin