title: Maximal medical therapy for chronic rhinosinusitis: a survey of otolaryngology consultants in the United Kingdom.
abstract: BACKGROUND
  The management of chronic rhinosinusitis is based on a trial of "maximal medical therapy" before surgery is considered. Ear-Nose-Throat (ENT) UK consultant members were surveyed to determine the role and variability of UK-wide practices.
  
  
  METHODS
  A survey was posted to all ENT UK consultant members (n = 603). This assessed the frequency of prescription, duration, and type of oral antibiotics, steroids, and antihistamines for chronic rhinosinusitis.
  
  
  RESULTS
  A total of 158 questionnaires (26.3%) were returned. Of these, 61% were primarily rhinologists. The use of decongestants, antifungals, and immunotherapy was generally limited. Oral antibiotics were often used, with clarithromycin of <5 weeks duration being the preferred choice. Sixty-one percent of consultants always prescribe a steroid spray, most commonly mometasone furoate (75%).
  
  
  CONCLUSIONS
  Although most respondents use triple therapy of oral antibiotics, steroid nasal spray, and saline douching to some extent, "maximal medical therapy" for chronic rhinosinusitis seems to vary greatly among consultants and frequently does not reflect recent guidelines.
authors.affiliation: Department of Otolaryngology, Bradford Royal Infirmary, Bradford, UK. dsylvester@doctors.net.uk
authors.forename: Deborah Claire
authors.initials: DC
authors.lastname: Sylvester
authors.forename: Simon
authors.initials: S
authors.lastname: Carr
authors.forename: Paul
authors.initials: P
authors.lastname: Nix
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001291:Attitude of Health Personnel; D002908:Chronic Disease; D006633:Histamine Antagonists / Q000008:administration & dosage; D006801:Humans; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012220:Rhinitis / Q000188:drug therapy*; D012852:Sinusitis / Q000188:drug therapy*; D013256:Steroids / Q000008:administration & dosage; D006113:United Kingdom
chemical_list: D000900:Anti-Bacterial Agents; D006633:Histamine Antagonists; D013256:Steroids