Abstract
We examined bacteria from the nasal cavities in 93 outpatients with relatively mild cases of paranasal sinusitis before and after 8 weeks of nasal nebulization with antibacterial agents performed 3 times a week.
The bacterial eradication rate was 28.0%. We observed that 42% of patients showed no bacterial change (4% with MIC increasing) and 30% showed superinfection (mainly with normal flora and 8% with resistant bacteria and fungi), among 50 patients who demonstrated bacteria before the start of this trial. We also observed post-trial bacterial appearance in 26% of 43 patients (46.2% of total) who demonstrated no bacteria before this trial. Among theses patients, almost all showed normal flora, but resistant bacteria and non-normal flora were found in 7% each.
In conclusion, local use of antibacterial agents for paranasal sinusitis has been thought to be more important as well as more effective than systemic treatment as a conservative therapy and the nebulization therapy is widely utilized because of its advantages as a painless therapy and its ability to spread an agent to plural paranasal sinuses simultaneously. However, we should avoid using nasal nebulization therapy unnecessarily over a long-term period because there is a chance of MIC increasing and superinfection with resistant bacteria and fungi.
