Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-23T07:51:53.185Z Has data issue: false hasContentIssue false
  • English
  • Français

Functional outcome after long-term low-dose trimethoprim/sulfamethoxazole in chronic rhinosinusitis with purulence: a prospective study

Published online by Cambridge University Press:  02 July 2018

G de Bonnecaze ,
B Chaput ,
A Dupret-Bories ,
S Vergez  and
E Serrano
G de Bonnecaze*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, University Hospital Rangueil-Larrey, Toulouse, France
B Chaput
Affiliation:
Plastic and Aesthetic Surgery, University Hospital Rangueil-Larrey, Toulouse, France
A Dupret-Bories
Affiliation:
Department of Surgery, Institut Universitaire du Cancer de Toulouse Oncopôle, France
S Vergez
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, University Hospital Rangueil-Larrey, Toulouse, France Department of Surgery, Institut Universitaire du Cancer de Toulouse Oncopôle, France
E Serrano
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, University Hospital Rangueil-Larrey, Toulouse, France
*
Address for correspondence: Dr Guillaume de Bonnecaze, 24 Chemin de Pouvourville, 31059 Toulouse, France E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

Trimethoprim/sulfamethoxazole has been suggested as a treatment option for chronic rhinosinusitis with purulence. This study aimed to assess the functional and endoscopic outcomes after a three-month course of low-dose trimethoprim/sulfamethoxazole.

Methods

A prospective study was performed, comprising patients referred to a tertiary care medical centre with a diagnosis of chronic rhinosinusitis with purulence. Trimethoprim/sulfamethoxazole was prescribed at 960 mg/day for three months. Sinonasal complaints and endoscopic findings were documented, and bacteriological data were compared.

Results

Fifteen patients were included. Staphylococcus aureus was the most common bacterium cultured (86 per cent). Improvement in nasal function, as measured by the 22-item Sino-Nasal Outcome Test, was highly significant at three months (p < 0.0005). This improvement slightly decreased but remained significant at 6, 9 and 12 months. No side effects were noted. Endoscopic scores revealed similar and concordant improvements.

Conclusion

Long-term low-dose trimethoprim/sulfamethoxazole therapy seems to be a safe option for selected patients. Additional randomised multicentre studies remain necessary.

Keywords

Trimethoprim-SulfamethoxazoleAntibiotherapyRhinosinusitis
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 7 , July 2018 , pp. 600 - 604
Copyright
Copyright © JLO (1984) Limited, 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr G de Bonnecaze takes responsibility for the integrity of the content of the paper

References

1Fokkens, WJ, Lund, VJ, Mullol, J, Bachert, C, Alobid, I, Baroody, F et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2012. Rhinol Suppl 2012;3:1–298Google Scholar
2Hellings, PW, Fokkens, WJ, Akdis, C, Bachert, C, Cingi, C, Dietz de Loos, D et al. Uncontrolled allergic rhinitis and chronic rhinosinusitis: where do we stand today? Allergy 2013;68:1–7Google Scholar
3Videler, WJ, van Hee, K, Reinartz, SM, Georgalas, C, van der Meulen, FW, Fokkens, WJ. Long-term low-dose antibiotics in recalcitrant chronic rhinosinusitis: a retrospective analysis. Rhinology 2012;50:45–55Google Scholar
4Cervin, A, Wallwork, B. Efficacy and safety of long-term antibiotics (macrolides) for the treatment of chronic rhinosinusitis. Curr Allergy Asthma Rep 2014;14:416–22Google Scholar
5Piromchai, P, Thanaviratananich, S, Laopaiboon, M. Systemic antibiotics for chronic rhinosinusitis without nasal polyps in adults. Cochrane Database Syst Rev 2011;(5):CD008233Google Scholar
6de Dorlodot, C, Horoi, M, Lefebvre, P, Collet, S, Bertrand, B, Eloy, P et al. French adaptation and validation of the sino-nasal outcome test-22: a prospective cohort study on quality of life among 422 subjects. Clin Otolaryngol 2015;40:29–35Google Scholar
7Rott, O, Mignon-Godefroy, K, Fleischer, B, Charreire, J, Cash, E. Superantigens induce primary T cell responses to soluble autoantigens by a non-V beta-specific mechanism of bystander activation. Cell Immunol 1995;161:158–65Google Scholar
8Khalid, AN, Hunt, J, Perloff, JR, Kennedy, DW. The role of bone in chronic rhinosinusitis. Laryngoscope 2002;112:1951–7Google Scholar
9Davis, LJ, Kita, H. Pathogenesis of chronic rhinosinusitis: role of airborne fungi and bacteria. Immunol Allergy Clin North Am 2004;24:59–73Google Scholar
10Post, JC, Stoodley, P, Hall-Stoodley, L, Ehrlich, GD. The role of biofilms in otolaryngologic infections. Curr Opin Otolaryngol Head Neck Surg 2004;12:185–90Google Scholar
11Pynnonen, MA, Venkatraman, G, Davis, GE. Macrolide therapy for chronic rhinosinusitis: a meta-analysis. Otolaryngol Head Neck Surg 2013;148:366–73Google Scholar
12Cervin, A, Kalm, O, Sandkull, P, Lindberg, S. One-year low-dose erythromycin treatment of persistent chronic sinusitis after sinus surgery: clinical outcome and effects on mucociliary parameters and nasal nitric oxide. Otolaryngol Head Neck Surg 2002;126:481–9Google Scholar
13Hashiba, M, Baba, S. Efficacy of long-term administration of clarithromycin in the treatment of intractable chronic sinusitis. Acta Otolaryngol Suppl 1996;525:73–8Google Scholar
14Wallwork, B, Coman, W, Mackay-Sim, A, Greiff, L, Cervin, A. A double-blind, randomized, placebo-controlled trial of macrolide in the treatment of chronic rhinosinusitis. Laryngoscope 2006;116:189–93Google Scholar
15Videler, WJ, Badia, L, Harvey, RJ, Gane, S, Georgalas, C, van der Meulen, FW et al. Lack of efficacy of long-term, low-dose azithromycin in chronic rhinosinusitis: a randomized controlled trial. Allergy 2011;66:1457–68Google Scholar
16Van Zele, T, Gevaert, P, Holtappels, G, Beule, A, Wormald, PJ, Mayr, S et al. Oral steroids and doxycycline: two different approaches to treat nasal polyps. J Allergy Clin Immunol 2010;125:1069–76Google Scholar
17Yoshihara, S, Kondo, K, Kanaya, K, Suzukawa, K, Baba, S, Toma-Hirano, M et al. Tumour necrosis factor inhibitor-associated sinusitis. Rhinology 2014;52:246–51Google Scholar
18Harvey, RJ, Wallwork, BD, Lund, VJ. Anti-inflammatory effects of macrolides: applications in chronic rhinosinusitis. Immunol Allergy Clin North Am 2009;29:689–703Google Scholar
19Chalermwatanachai, T, Velásquez, LC, Bachert, C. The microbiome of the upper airways: focus on chronic rhinosinusitis. World Allergy Organ J 2015;8:3Google Scholar
20Desrosiers, MY, Salas-Prato, M. Treatment of chronic rhinosinusitis refractory to other treatments with topical antibiotic therapy delivered by means of a large-particle nebulizer: results of a controlled trial. Otolaryngol Head Neck Surg 2001;125:265–9Google Scholar