The role of antibiotics in treating chronic rhinosinusitis.
Chronic rhinosinusitis (CRS) is an inflammatory disease of the paranasal sinuses that occurs in 1% to 5% of the U.S. It may significantly decrease quality of life. CRS is defined as an inflammatory condition of the paranasal sinuses that persists for 12 weeks or longer, despite medical management. Treatment is directed at enhancing mucociliary clearance, improving sinus drainage/outflow, eradicating local infection (with antibiotics) and inflammation (with steroids), and improving access for topical medications. The microbiology of rhinosinusitis e volves through several stages . The early phase (acute) is generally caused by a virus that may be followed by an aerobic bacterial infection in 2% to 10% of patients. Aerobic ( Staphylococcus aureus ) and anaerobic (Prevotella and Fusobacteria) members of the oral flora emerge as predominant sinus cavity isolates. Antimicrobials are one component of comprehensive medical and surgical management for this disorder. Antimicrobialtherapy of chr