Irrigation therapy for acute rhinosinusitis: possible complications

Irrigation therapy is widely used in clinical practice for the treatment of acute rhinosinusitis. One of the methods of irrigation therapy is the Proetz method. This method has many contraindications and is associated with the development of a number of complications, which are not always taken into account by otorhinolaryngologists. We present a number of observations of complications associated with an uncontrolled pressure decrease in the nasal cavity and paranasal sinuses.

Possibilities of tropical treatment of bacterial ENT infections

The overuse and inappropriate use of systemic antibiotics is the most serious cause of problems associated with the increasing resistance of bacterial pathogens. What served as the basis for WHO to call the XXI century “The era of antibiotic resistance”. The wide spread of resistant strains of microorganisms, the growth of severe and complicated forms of diseases leads to an increase in the frequency of unfavorable treatment outcomes. In the Russian Federation, an increase in the incidence of acute rhinosinusitis from 4.6 to 12.7 cases per 1000 population has been noted in the last decade. The incidence of acute rhinosinusitis in Europe is recorded in 6.4 ± 3.6 of all cases of visits to primary care physicians. Up to 38% of outpatients in the ENT profile suffer from various forms of otitis media, including up to 30% of acute otitis media. The most important way to overcome the global problem of antibiotic resistance, along with the delayed use of systemic antibacterial drugs initiated by the world medical community, is to switch to the active use of topical drugs with antimicrobial activity. The article provides an overview of the data of domestic and foreign literature on the properties of a topical antibacterial drug with the active ingredient hydroxymethylquinoxaline dioxide. The results of experimental work and clinical studies, proving the high efficacy and safety of the drug in the complex treatment of bacterial infections of the upper respiratory tract, have been analyzed.

Features of the use of topical preparations of framycetin sulfate in the treatment of rhinosinusitis

Introduction. Acute rhinosinusitis is one of the most common infectious diseases in the world. But despite their predominantly viral nature, the activation of their own microflora occurring during the disease, the addition of pathogenic and the associated risks of rhinogenic complications lead to the widespread use of antibacterial therapy for this pathology. Local antiseptics, such as framycetin sulfate in the form of nasal spray, play an important role in the multicomponent structure of rhinosinusitis therapy.The aim of the study was to evaluate the effect of an aerosol preparation of framycetin sulfate of domestic and imported production on the activity of the atrial fibrillation of the nasal cavity as topical antibacterial therapy in acute rhinosinusitis.Materials and methods. The study included 30 adult patients diagnosed with acute rhinosinusitis. The patients were randomized into 2 equal groups and received standard therapy for this disease, according to clinical recommendations. The differences in the groups concerned only topical antibacterial therapy. The 1st experimental group used a drug of domestic production, the 2nd group - a control group, used an imported framycetin spray.Results. Data were obtained not only comparing the clinical picture depending on the treatment, but also information about the effect of the drug on the activity of the atrial epithelium of the nasal cavity, the distribution of the substance in the nasal cavity, and even considered the structural differences of the vials that affect the distribution of the drug during injection. Conclusion. Topical antibacterial therapy with framycetin sulphate is an effective method in complex treatment of acute rhinosinusitis. Innovative technologies for the creation of an aerosol of framicetin solution allow to achieve stable dosage of the drug during use.

Topical antibiotics for acute rhinosinusitis in children

The authors presented an overview of the existing data on inhalation therapy with antibacterial drugs in acute rhinosinusitis and exacerbation of chronic rhinosinusitis in children. The overview includes general information about the etiology and features of the course of acute rhinosinusitis. It also contains indications for systemic and topical antibiotic therapy in acute rhinosinusitis specified in the Russian clinical guidelines. The advantages of using a combination preparation of thiampheni-col and N-acetylcysteine by inhalation therapy for acute rhinosinusitis in children and adults are considered separately. A clinical case of a 15-year-old female patient with complaints of persistent rhinitis over the past 4-5 years is discussed. Historical information: a patient had a runny nose over the last 4-5 years: persistent, viscous nasal discharge with moderate nasal congestion. Nasal symptoms worsened with episodes of acute respiratory illness, and nasal discharge became mucopurulent. The child was preliminarily diagnosed with chronic rhinosinusitis (incomplete remission), moderate course. To reduce the severity of the symptoms of the disease, which were present at the time of examination, the following were recommended: daily one-to-two irrigation of the nasal cavity with slightly hypertonic (1.5-3%) solutions of sea water, followed by a toilet of the nasal cavity; in case of episodes of colds with the appearance of mucopurulent secretions, inhalation therapy in a pulsating mode of the inhaler with a solution of thiamphenicol and N-acetylcysteine at a dose of 500 mg once a day (in the first half of the day) for the next 10 days and further; the use of a nasal spray of mometasone furoate, 200 mcg per day during inhalation therapy for another 3 weeks. At the follow-up examination after 10 days of treatment, the patient reported a significant decrease in the severity of nasal symptoms, which coincided with an improvement in the rhinoscopic status. It can be concluded that the use of topical antibacterial drugs by inhalation therapy for acute rhinosinusitis, despite all its advantages, is not an equivalent substitute for systemic antibiotic therapy in the treatment of severe and especially complicated forms of the disease. The inhalation therapy is recommended in the presence of indications for systemic antibiotic therapy, since it is an auxiliary method of treatment, the action of which is aimed at enhancing the effect of systemic antibiotics.