title: Sinonasal methicillin-resistant Staphylococcus aureus: updates on treatment.
abstract: OBJECTIVE
  Over the past two decades, the management of methicillin-resistant Staphylococcus aureus (MRSA) in chronic rhinosinusitis has posed significant challenges. This document reviews current management techniques and novel treatment modalities for sinonasal MRSA infections.
  
  
  RESULTS
  Topical antibiotic therapy, that is, drops (ofloxacin) and ointments (mupirocin) as off-label use for the management of MRSA chronic sinusitis, has shown beneficial results. Other more recently trialed nonantibiotic modalities such as antimicrobial photodynamic therapy and colloidal silver irrigation are also showing promise.
  
  
  CONCLUSIONS
  Sinonasal MRSA is considered to be associated with recalcitrant chronic sinusitis. Advancements in systemic and local antibiotics in its management have been slow and unsatisfactory. Attention is shifting to the use of nonantibiotic antibacterial treatments. Knowledge of these options is critical to improve the overall management of these chronic patients.
authors.affiliation: St. Paul's Sinus Centre, Department of Surgery, University of British Columbia, Vancouver, Canada.
authors.forename: Fahad
authors.initials: F
authors.lastname: Al-Asousi
authors.forename: Anali
authors.initials: A
authors.lastname: Dadgostar
authors.forename: Amin
authors.initials: A
authors.lastname: Javer
mesh_terms: D000281:Administration, Intranasal; D000284:Administration, Oral; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000494:pharmacology; D002908:Chronic Disease; D005260:Female; D006722:Honey; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D055556:Nasal Lavage / Q000379:methods; D010778:Photochemotherapy / Q000379:methods; D012220:Rhinitis / Q000382:microbiology / Q000628:therapy*; D012834:Silver / Q000494:pharmacology; D012852:Sinusitis / Q000382:microbiology / Q000628:therapy*; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents; C586932:colloidal silver; D012834:Silver