title: Judicious antibiotic use and intranasal corticosteroids in acute rhinosinusitis.
abstract: Most patients with symptoms of acute rhinosinusitis are treated with antibiotics. However, many cases of rhinosinusitis are secondary to viral infections and unlikely to benefit from antibiotic therapy. Inappropriate use of antibiotics in patients with acute nonbacterial rhinosinusitis contributes to the increase in bacterial antibiotic resistance. Consequently, safe and effective alternatives to antibiotics are needed in the treatment of acute rhinosinusitis caused by viral infections. Recent results from controlled trials have shown that intranasal corticosteroids, used in combination with antibiotics or as monotherapy in selected cases, provide significant symptom relief and resolution of acute rhinosinusitis. The use of intranasal corticosteroids in acute rhinosinusitis therefore might reduce the inappropriate use of antimicrobial therapy in acute rhinosinusitis.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, New York Medical College, Westchester Medical Center, Valhalla 10595, USA. Catherine_Small@nymc.edu
authors.forename: Catherine Butkus
authors.initials: CB
authors.lastname: Small
authors.forename: Claus
authors.initials: C
authors.lastname: Bachert
authors.forename: Valerie J
authors.initials: VJ
authors.lastname: Lund
authors.forename: Augustine
authors.initials: A
authors.lastname: Moscatello
authors.forename: Anjuli S
authors.initials: AS
authors.lastname: Nayak
authors.forename: William E
authors.initials: WE
authors.lastname: Berger
mesh_terms: D000208:Acute Disease; D000281:Administration, Intranasal; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D006801:Humans; D017410:Practice Guidelines as Topic; D012220:Rhinitis / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D012852:Sinusitis / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D016896:Treatment Outcome; D019564:Unnecessary Procedures
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents