Bacteriological findings and antimicrobial susceptibility in chronic sinusitis with nasal polyp.
CONCLUSIONS
We recommend amoxacillin/clavulanate, cephalosporins and macrolides rather than penicillin as the first-line drug in chronic sinusitis with nasal polyps. In cases where there is no improvement of symptoms, cultures should be taken from the middle meatus, followed by appropriate selection of second-line antibiotics according to the sensitivity test results.


OBJECTIVE
To investigate the causative bacteria and the antimicrobial susceptibility in patients with chronic sinusitis and nasal polyps in Korea.


METHODS
The bacteriology and antimicrobial susceptibility of maxillary sinus aspirates from 81 patients were evaluated.


RESULTS
Aerobes were isolated from 58.0% of the cultures from the middle meatus and from 48.1% of those from the maxillary sinus. Staphylococcus aureus, Haemophilus influenzae, and Streptococcus pneumoniae were the most prevalent aerobic pathogens. Anaerobes were isolated from 8.6% of the cultures from the middle meatus and from 18.5% of the cultures from the maxillary sinus. The predominant anaerobic organisms were Prevotella and Peptostreptococcus in adults but none of them were cultured in children. A high rate of concordance of the middle meatus and maxillary sinus was noted. Monomicrobial infection was most commonly observed. Ampicillin-resistant H. influenzae isolates were cultured in 46% of the cases. Penicillin resistance rates were 93% for Staph. aureus; 25% of Strep. pneumoniae were intermediate and 25% were resistant.
Kim
Hyun Jun
HJ
Department of Otolaryngology, Ajou University, Suwon, Korea.
Lee
Kyungwon
K
Yoo
Jong-Bum
JB
Song
Jung-Whan
JW
Yoon
Joo-Heon
JH
D000293:Adolescent; D000328:Adult; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D001421:Bacteria, Anaerobic / Q000187:drug effects; D001424:Bacterial Infections / Q000188:drug therapy / Q000382:microbiology*; D001431:Bacteriological Techniques; D002511:Cephalosporins / Q000627:therapeutic use; D002648:Child; D002908:Chronic Disease; D005260:Female; D006192:Haemophilus Infections / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D018942:Macrolides / Q000627:therapeutic use; D008297:Male; D008443:Maxillary Sinus / Q000382:microbiology; D015523:Maxillary Sinusitis / Q000188:drug therapy / Q000382:microbiology*; D008826:Microbial Sensitivity Tests; D009297:Nasal Mucosa / Q000382:microbiology; D009298:Nasal Polyps / Q000188:drug therapy / Q000382:microbiology*; D010403:Penicillin Resistance; D011008:Pneumococcal Infections / Q000188:drug therapy / Q000382:microbiology; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000382:microbiology; D013223:Statistics as Topic; D016896:Treatment Outcome
D000890:Anti-Infective Agents; D002511:Cephalosporins; D018942:Macrolides; D019980:Amoxicillin-Potassium Clavulanate Combination