Topical Antimicrobials in the Management of Chronic Rhinosinusitis: A Systematic Review

Abstract

Topical antibiotics appear effective in the management of CRS. Given the combination of low-level evidence (level III, with inherent potential confounders of natural progression of disease and placebo effect) and the level IIb evidence being limited to the cystic fibrosis group of patients, topical antibiotics should not be first-line management but may be attempted in patients refractory to the traditional topical steroids and oral antibiotics. Larger and better-designed randomized double-blind placebo-controlled trials are required to more fully evaluate this emerging modality of treatment.

Extensive Surgical and Comprehensive Postoperative Medical Management for Cystic Fibrosis Chronic Rhinosinusitis

“…Topical nasal steroids have been shown to reduce polyp size and associated symptoms. 22,23 In a recent systematic literature review, Lim et al 24 concluded that the use of topical antimicrobials in the management of CRS is efficacious. However, this therapeutic approach may be limited by poor penetration of treatment agents.…”

Antifungal Therapy in the Treatment of Chronic Rhinosinusitis: A Meta-Analysis

“…47,48 Three more trials were included in this review. 36,37,39 No meta-analysis was performed in the study by Lim et al 46 Rather, it was purely qualitative.…”

Current views on chronic rhinosinusitis in patients with cystic fibrosis

“…Существует один систематический обзор, по-священный применению топической антимикроб-ной терапии у пациентов с хроническим риносину-ситом, включающий также данные об эффективно-сти данного метода лечения при МВ [24]. Поиск был проведен по базам MEDLINE, EMBASE и CINAHL, а также Кохрановскому центральному регистру кон-тролируемых исследований и Кохрановской базе системных обзоров.…”