title: Oral corticosteroid prescribing habits for rhinosinusitis: The American Rhinologic Society membership.
abstract: BACKGROUND
  In the field of otolaryngology, oral corticosteroids (OCS) are widely prescribed for rhinosinusitis. Although there is evidence in the literature regarding specific OCS dosing protocols, it is not known to what extent these recommendations are being followed.
  
  
  OBJECTIVE
  To examine the current state of OCS prescribing habits for rhinosinusitis by American Rhinologic Society members.
  
  
  METHODS
  An anonymous online survey was sent to all American Rhinologic Society members. Dosing, frequency, tapering, and overall prescribing habits for OCS were assessed in chronic rhinosinusitis with polyposis (CRSwP) and in chronic rhinosinusitis without polyposis and acute bacterial rhinosinusitis. The CRSwP group was subdivided into aspirin-exacerbated respiratory disease, allergic fungal sinusitis, and not otherwise specified. Results were compared with current guidelines. Descriptive statistics were used to analyze data.
  
  
  RESULTS
  Ninety-three surveys were completed (response rate, 12.9%). Prednisone was the most common OCS prescribed. In the CRSwP-aspirin-exacerbated respiratory disease group (n = 86), the median starting dose was 60 mg (range, 4-80 mg) and the average duration was 8 days (range, 2-28 days). In the CRSwP-allergic fungal sinusitis group (n = 81), the median starting dose was 50 mg (range, 20-60 mg), and the average duration was 6 days (range, 2-35 days). In the CRSwP-not otherwise specified group (n = 84), the median starting dose was 50 mg (range, 20-80 mg) and the average duration was 5 days (range, 1-21 days). OCS were prescribed for chronic rhinosinusitis without polyposis and acute bacterial rhinosinusitis by 66.0 and 62.4% of respondents, respectively.
  
  
  CONCLUSIONS
  Significant heterogeneity existed in OCS prescribing habits for rhinosinusitis. Discrepancies were observed between survey results and evidence-based recommendations. Developing standardized OCS treatment protocols for rhinosinusitis may improve the quality of care by optimizing clinical outcomes and reducing the risk of complications.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
authors.forename: John R
authors.initials: JR
authors.lastname: Scott
authors.forename: Hannah M J
authors.initials: HM
authors.lastname: Ernst
authors.forename: Brian W
authors.initials: BW
authors.lastname: Rotenberg
authors.forename: Luke
authors.initials: L
authors.lastname: Rudmik
authors.forename: Leigh J
authors.initials: LJ
authors.lastname: Sowerby
mesh_terms: D000284:Administration, Oral; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D001241:Aspirin / Q000627:therapeutic use*; D002908:Chronic Disease; D019317:Evidence-Based Medicine; D006801:Humans; D010036:Otolaryngology / Q000639:trends; D010818:Practice Patterns, Physicians'; D011241:Prednisone / Q000627:therapeutic use*; D012220:Rhinitis / Q000188:drug therapy / Q000453:epidemiology*; D012852:Sinusitis / Q000188:drug therapy / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
chemical_list: D000305:Adrenal Cortex Hormones; D001241:Aspirin; D011241:Prednisone