MedStar Authors catalog › Details for: Topical therapy for refractory rhinosinusitis caused by methicillin-resistant Staphylococcus aureus: First report in a prospective series.
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Topical therapy for refractory rhinosinusitis caused by methicillin-resistant Staphylococcus aureus: First report in a prospective series.

by Shikani, Alan; Khoueir, Nadim.
Citation: Auris, Nasus, Larynx. 45(5):994-999, 2018 Oct..Journal: Auris, nasus, larynx.Published: 2018ISSN: 0385-8146.Full author list: Shikani AH; Khoueir N; Jabra-Rizk MA; Shikani HJ; Basaraba RJ; Leid JG.UI/PMID: 29426723.Subject(s): Administration, Intranasal | Administration, Topical | Adult | Aged | *Anti-Bacterial Agents/ad [Administration & Dosage] | Anti-Inflammatory Agents/ad [Administration & Dosage] | Cellulose/aa [Analogs & Derivatives] | Culture Techniques | Debridement | Endoscopy | Female | Humans | Instillation, Drug | Male | Methicillin-Resistant Staphylococcus aureus | Microbial Sensitivity Tests | Middle Aged | Mometasone Furoate/ad [Administration & Dosage] | Mupirocin/ad [Administration & Dosage] | Nebulizers and Vaporizers | Prospective Studies | *Rhinitis/dt [Drug Therapy] | Rhinitis/mi [Microbiology] | Rhinitis/su [Surgery] | *Sinusitis/dt [Drug Therapy] | Sinusitis/mi [Microbiology] | Sinusitis/su [Surgery] | *Staphylococcal Infections/dt [Drug Therapy] | Staphylococcal Infections/mi [Microbiology] | Staphylococcal Infections/su [Surgery] | Therapeutic Irrigation | Tobramycin/ad [Administration & Dosage] | Treatment Outcome | Vancomycin/ad [Administration & Dosage]Institution(s): MedStar Union Memorial HospitalDepartment(s): Maryland Nose & Sinus CenterActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access online Digital Object Identifier: https://dx.doi.org/10.1016/j.anl.2018.01.009 (Click here) Abbreviated citation: Auris Nasus Larynx. 45(5):994-999, 2018 Oct.Local Holdings: Available online through MWHC library: 2008 - present.Abstract: OBJECTIVE: The incidence of refractory chronic rhinosinusitis (CRS) associated with methicillin-resistant Staphylococcus aureus (MRSA) is rising and remains a therapeutic challenge. The goal of this study is to demonstrate the efficacy of a non-invasive topical therapy against MRSA in these patients.Abstract: METHODS: Seventeen patients with refractory CRS caused by MRSA were treated with a topical therapy protocol. Treatment consisted of weekly endoscopic sinus debridement followed by intra-sinus installation of a hydroxyl-ethylcellulose gel that releases mometasone and a culture-directed antibiotic for a period of 6 weeks, along with daily nasal nebulization of mometasone with the same antibiotic and saline rinses. Clinical outcome was assessed using the Lund-Kennedy (LK) symptom and endoscopic appearance scores. Sinus mucosal tissue was homogenized and cultured, and microbial biofilm burden was assessed based on colony forming units (CFUs) counts.Abstract: RESULTS: Rhinotopic therapy resulted in clearance of MRSA in 13 of 16 patients (81.2%). Treated patients also demonstrated significant improvement clinically as measured by the LK scores. In addition, a significant decrease in mucosal CFUs was observed post-therapy.Abstract: CONCLUSION: Our findings demonstrate that topical therapy is an effective method for treating MRSA-associated refractory CRS.Abstract: Copyright (c) 2018. Published by Elsevier B.V.

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