xRead - Nasal Obstruction (September 2024) Full Articles

20426984, 2021, 3, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/alr.22741 by Stanford University, Wiley Online Library on [01/07/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License

417

Orlandi et al.

biofilm in recalcitrant CRScases.

Topical culture-directed antibiotics may be beneficial in

recalcitrant CRS.

Higher-level studies are needed.

budesonide irrigations

may reduce symptoms ofCRS.

Hyaluronate-tobramycin spray failed to improve symptoms or bacterial load in CF patients.

No benefit seen with topical antibiotic.

reduce bacteria but may lead to overgrowth of

Corynebacterium and

gram-negative bacteria.

Culture Topical therapy did not

Study Year LOE Study Design Study Groups Clinical Endpoint Conclusions NasalMCC Sinus X-ray

Ofloxacin may reduce

Azithromycin added to

Nasal rhinomanometry Bacterial cx Nasal endoscopy Symptoms

Nasal endoscopy CTscan Culture SEM

Symptoms

Nasal endoscopy Culture

Symptoms

Nasal endoscopy

Symptoms

Nasal endoscopy Bacterial load Tolerability

Recalcitrant CRS high volume culture-directed antibiotics BID for 1 month (n = 58)

Sykes 1074 1986 2 DBRCT Neomycin, tramazoline, dexamethasone (n = 20)

mupirocin irrigations for at least 1 week (n = 22)

Topical ofloxacin drops 12 weeks (n = 15) No antibiotics (n = 25)

2. Hyaluronate-tobramycin nasal spray (n = 14)

Tramazoline, dexamethasone (n = 20) Placebo (n = 10)

Recalcitrant CRS after ESS and failed BID budesonide. Added azithromycin TIW (n = 12)

1. Hyaluronate nasal spray (n = 13)

DiCicco 1152 2014 3 DBRCT pilot study Patients with CF

Carr 1145 2016 4 Case series Recalcitrant CRS BID

controlled trial

Lee 1153 2016 4 Retrospective case series

Maniakas 1154 2014 4 Retrospective case series

Ezzat 1151 2015 3* Prospective,

TABLE IX-33 (Continued)

*insufficient information, high risk of bias, downgraded to 3.