title: Prevalence of biofilms and their response to medical treatment in chronic rhinosinusitis without polyps.
abstract: OBJECTIVE
  The aim of this study was to investigate the prevalence of biofilms and the effects of medical treatment modalities in chronic rhinosinusitis (CRS) patients without nasal polyps.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Tertiary referral hospital.
  
  
  METHODS
  The authors randomly divided 32 adult patients with CRS without nasal polyps into 2 groups. In the first group (n = 16), oral clarithromycin was administered 500 mg/bid for 2 weeks and then 250 mg/d for the following 6 weeks. In the second group (n = 16), an 8-week course of 200-mcg/d topical mometasone furoate was added to the clarithromycin regimen, identical to the first group. The pre- and posttreatment nasal tissue samples were evaluated by scanning electron microscopy for biofilm prevalence and graded from 0 to 3 according to density and extension.
  
  
  RESULTS
  Biofilms were detected in 24 of 32 patients (75%) before the treatment (grades 1-3). Biofilms were detected in 14 of 32 patients (43.8%) after the treatment (grades 1-2). When each group was evaluated independently, there was a significant improvement after the treatment in both groups I and II. When the biofilm grades of group I were compared to those of group II, there was no significant difference both in the pre- and posttreatment evaluation.
  
  
  CONCLUSIONS
  The prevalence of biofilms in CRS without polyps was 75% in our study. Regression of biofilms to 43% was observed under medical treatment. Adding nasal steroids to macrolides gave no further benefit.
authors.affiliation: Ministry of Health, Dişkapi Yildirim Beyazit Training and Research Hospital, Department of Otolaryngology, Ankara, Turkey. ectatar@gmail.com
authors.forename: Emel Çadalli
authors.initials: EÇ
authors.lastname: Tatar
authors.forename: Ilkan
authors.initials: I
authors.lastname: Tatar
authors.forename: Bülent
authors.initials: B
authors.lastname: Ocal
authors.forename: Hakan
authors.initials: H
authors.lastname: Korkmaz
authors.forename: Güleser
authors.initials: G
authors.lastname: Saylam
authors.forename: Ali
authors.initials: A
authors.lastname: Ozdek
authors.forename: Hakan Hamdi
authors.initials: HH
authors.lastname: Celik
mesh_terms: D000284:Administration, Oral; D000287:Administration, Topical; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D018441:Biofilms / Q000187:drug effects*; D001706:Biopsy; D002908:Chronic Disease; D017291:Clarithromycin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D000068656:Mometasone Furoate; D011244:Pregnadienediols / Q000008:administration & dosage; D015995:Prevalence; D012220:Rhinitis / Q000188:drug therapy* / Q000382:microbiology*; D012852:Sinusitis / Q000188:drug therapy* / Q000382:microbiology*; D018709:Statistics, Nonparametric
chemical_list: D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D011244:Pregnadienediols; D000068656:Mometasone Furoate; D017291:Clarithromycin