Topical Antibiotic, Antifungal, and Antiseptic Solutions Decrease Ciliary Activity in Nasal Respiratory Cells

Gosepath, Jan; Grebneva, Nina; Mossikhin, Sergey; Mann, Wolf J.

doi:10.1177/194589240201600105

Cited by 37 publications

(31 citation statements)

References 7 publications

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“…275,283,284 There is also the potential for inducing fungal resistance due to the low concentrations used in topical formulations. Multiple trials used concentrations of amphotericin B at 100 µg/mL, a concentration that has been documented to not impede fungal growth in vitro compared with true inhibition at 200 and 300 µg/mL.…”

Section: Role Of Fungi In Crsmentioning

confidence: 99%

Clinical Practice Guideline (Update): Adult Sinusitis

Rosenfeld

Piccirillo

Chandrasekhar³

et al. 2015

Otolaryngol.--head neck surg.

931

1,303

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The update group made strong recommendations that clinicians (1) should distinguish presumed ABRS from acute rhinosinusitis (ARS) caused by viral upper respiratory infections and noninfectious conditions and (2) should confirm a clinical diagnosis of CRS with objective documentation of sinonasal inflammation, which may be accomplished using anterior rhinoscopy, nasal endoscopy, or computed tomography. The update group made recommendations that clinicians (1) should either offer watchful waiting (without antibiotics) or prescribe initial antibiotic therapy for adults with uncomplicated ABRS; (2) should prescribe amoxicillin with or without clavulanate as ﬁrst-line therapy for 5 to 10 days (if a decision is made to treat ABRS with an antibiotic); (3) should reassess the patient to confirm ABRS, exclude other causes of illness, and detect complications if the patient worsens or fails to improve with the initial management option by 7 days after diagnosis or worsens during the initial management; (4) should distinguish CRS and recurrent ARS from isolated episodes of ABRS and other causes of sinonasal symptoms; (5) should assess the patient with CRS or recurrent ARS for multiple chronic conditions that would modify management, such as asthma, cystic fibrosis, immunocompromised state, and ciliary dyskinesia; (6) should confirm the presence or absence of nasal polyps in a patient with CRS; and (7) should recommend saline nasal irrigation, topical intranasal corticosteroids, or both for symptom relief of CRS. The update group stated as options that clinicians may (1) recommend analgesics, topical intranasal steroids, and/or nasal saline irrigation for symptomatic relief of viral rhinosinusitis; (2) recommend analgesics, topical intranasal steroids, and/or nasal saline irrigation) for symptomatic relief of ABRS; and (3) obtain testing for allergy and immune function in evaluating a patient with CRS or recurrent ARS. The update group made recommendations that clinicians (1) should not obtain radiographic imaging for patients who meet diagnostic criteria for ARS, unless a complication or alternative diagnosis is suspected, and (2) should not prescribe topical or systemic antifungal therapy for patients with CRS.

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Section: Role Of Fungi In Crsmentioning

confidence: 99%

Clinical Practice Guideline (Update): Adult Sinusitis

Rosenfeld

Piccirillo

Chandrasekhar³

et al. 2015

Otolaryngol.--head neck surg.

931

1,303

View full text Add to dashboard Cite

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“…Other studies have shown an impaired CBF in patients with allergic rhinitis or asthma 4, 5, 6, 7. Certain topical antibiotics have been shown to reduce the CBF and thus cannot be recommended in treatment of local infections 8. Pathogens targeting the airway like Pseudomonas aeruginosa , Streptococcus pneumoniae , or Haemophilus influenzae produce various cilio‐inhibitory factors 9, 10, 11, 12.…”

mentioning

confidence: 99%

Non-diluted seawater enhances nasal ciliary beat frequency and wound repair speed compared to diluted seawater and normal saline

Bonnomet

Luczka

Coraux

et al. 2016

Int Forum Allergy Rhinol.

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BackgroundThe regulation of mucociliary clearance is a key part of the defense mechanisms developed by the airway epithelium. If a high aggregate quality of evidence shows the clinical effectiveness of nasal irrigation, there is a lack of studies showing the intrinsic role of the different irrigation solutions allowing such results. This study investigated the impact of solutions with different pH and ionic compositions, eg, normal saline, non‐diluted seawater and diluted seawater, on nasal mucosa functional parameters.MethodsFor this randomized, controlled, blinded, in vitro study, we used airway epithelial cells obtained from 13 nasal polyps explants to measure ciliary beat frequency (CBF) and epithelial wound repair speed (WRS) in response to 3 isotonic nasal irrigation solutions: (1) normal saline 0.9%; (2) non‐diluted seawater (Physiomer®); and (3) 30% diluted seawater (Stérimar). The results were compared to control (cell culture medium).ResultsNon‐diluted seawater enhanced the CBF and the WRS when compared to diluted seawater and to normal saline. When compared to the control, it significantly enhanced CBF and slightly, though nonsignificantly, improved the WRS. Interestingly, normal saline markedly reduced the number of epithelial cells and ciliated cells when compared to the control condition.ConclusionOur results suggest that the physicochemical features of the nasal wash solution is important because it determines the optimal conditions to enhance CBF and epithelial WRS thus preserving the respiratory mucosa in pathological conditions. Non‐diluted seawater obtains the best results on CBF and WRS vs normal saline showing a deleterious effect on epithelial cell function.

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“…Gosepath et al [19] studied whether antiseptic, antibiotic, and antifungal topical solutions (including amphotericin B) used in CRS treatment infl uence nasal mucociliary clearance by affecting the ciliary beat frequency (CBF) of nasal respiratory cells. In a prospective study, nasal respiratory cells were harvested from healthy individuals.…”

Section: Effect Of Amphotericin On Mucociliary Clearancementioning

confidence: 99%

Antifungal treatment and chronic rhinosinusitis

Lal

Stankiewicz

2009

Curr Allergy Asthma Rep

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Chronic rhinosinusitis (CRS) is an inflammatory disease with a multifactorial etiology. Antifungal therapy is not routinely used to treat it. However, evidence implicating fungi in some forms of CRS recently has been published. Controversy exists as to whether fungi identified in sinonasal cultures are always pathogenic. Immunologic evidence supporting the role of fungi in the pathogenesis of CRS is also debated. Topical antifungal therapy is more widely used than oral therapy, with amphotericin B irrigation being the most common. Although some studies show benefit from this irrigation, others refute the efficacy. Although oral antifungal agents are used uncommonly, itraconazole is the most commonly used drug. The efficacy of oral itraconazole in CRS has never been assessed in a clinical trial. Given the current evidence, the use of antifungals to treat CRS is controversial and has limited indications.

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Topical Antibiotic, Antifungal, and Antiseptic Solutions Decrease Ciliary Activity in Nasal Respiratory Cells

Cited by 37 publications

References 7 publications

Clinical Practice Guideline (Update): Adult Sinusitis

Clinical Practice Guideline (Update): Adult Sinusitis

Non-diluted seawater enhances nasal ciliary beat frequency and wound repair speed compared to diluted seawater and normal saline

Antifungal treatment and chronic rhinosinusitis

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