title: Intranasal corticosteroid use is associated with lower rates of bacterial recovery in chronic rhinosinusitis.
abstract: OBJECTIVE
  To determine whether use of a topical intranasal corticosteroid (INCS) preoperatively had an effect on the bacterial recovery rate and flora recovered at endoscopic sinus surgery (ESS).
  
  
  METHODS
  A prospective, multicenter, observational study from academic-based rhinology practices. Consecutive, unselected patients undergoing ESS had protected sinus cultures done at the time of ESS.
  
  
  RESULTS
  157 patients were assessed. Overall growth rate was 45.5%. INCS users had a positive culture rate of 35.4% vs 61.7% in nonusers (P = 0.0001). This effect was most pronounced in the subgroup undergoing revision surgeries (bacterial recovery rate INCS: 40.0%, no INCS: 82.6%, P = 0.001) and most marked for S. aureus (INCS: 12.5%, no INCS: 40.0%, P = 0.04) and CNS (INCS: 12.5%, no INCS: 30.4%, P = 0.05). While the rate of nasal polyposis was higher in both revision and the INCS-treated groups, rate of bacterial recovery was not influenced by a diagnosis of nasal polyposis.
  
  
  CONCLUSIONS
  INCS use preoperatively is associated with a lesser rate of bacterial recovery at the time of ESS, especially in individuals with previous ESS.
  
  
  CONCLUSIONS
  The results suggest a possible role of INCS in the management of post-ESS disease.
authors.affiliation: Canadian Society of Otololaryngology-Head and Neck Surgery Rhinology group and Department of Otolaryngology, Hotel-Dieu de Montreal, Montreal, Quebec, Canada. desrosiers_martin@hotmail.com
authors.forename: Martin
authors.initials: M
authors.lastname: Desrosiers
authors.forename: Abdolmohsen
authors.initials: A
authors.lastname: Hussain
authors.forename: Saul
authors.initials: S
authors.lastname: Frenkiel
authors.forename: Shaun
authors.initials: S
authors.lastname: Kilty
authors.forename: Joseph
authors.initials: J
authors.lastname: Marsan
authors.forename: Ian
authors.initials: I
authors.lastname: Witterick
authors.forename: Erin
authors.initials: E
authors.lastname: Wright
mesh_terms: D000281:Administration, Intranasal; D002908:Chronic Disease; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D011241:Prednisone / Q000008:administration & dosage*; D011446:Prospective Studies; D012220:Rhinitis / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology* / Q000601:surgery; D012852:Sinusitis / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology* / Q000601:surgery; D013210:Staphylococcus / Q000302:isolation & purification*
chemical_list: D005938:Glucocorticoids; D011241:Prednisone