Sinusitis antimicrobials

Church D, et al. Efficacy of moxifloxacin in the treatment of acute bacterial sinusitis caused by penicillin-resistant Streptococcus pneumoniae. In 40th Interscience Conference on Antimicrobial Agents and Chemotherapy, Abstract 833. Toronto, 2000. 

Benninger MS. Amoxicillin/clavulanate potassium extended release tablets a new antimicrobial for the treatment of acute bacterial sinusitis and community-acquired pneumonia. Expert Opin Pharmacother 2003 Oct 4(10) 1839-1846. 

The proper route of administration for an antimicrobial depends on the site of infection. Parenteral therapy is warranted when patients are being treated for febrile neutropenia or deep-seated infections such as meningitis, endocarditis, and osteomyelitis. Severe pneumonia often is treated initially with intravenous antibiotics and switched to oral therapy as clinical improvement is evident. Patients treated in the ambulatory setting for upper respiratory tract infections (e.g., pharyngitis, bronchitis, sinusitis, and otitis media), lower respiratory tract infections, skin and soft tissue infections, uncomplicated urinary tract infections, and selected sexually transmitted diseases may receive oral therapy. 

Sinusitis is an inflammation and/or infection of the paranasal sinus mucosa. The term rhinosinusitis is used by some specialists because sinusitis typically also involves the nasal mucosa. " The majority of these infections are viral in origin nevertheless, antimicrobials are prescribed frequently. It is thus important to differentiate between viral and bacterial sinusitis to aid in optimizing treatment decisions. 

Maxillary tooth pain, facial or sinus pain that may radiate (unilateral in particular) as well as deterioration after initial improvement Severe or persistent (beyond 7 days) signs and symptoms are most likely bacterial and should be treated with antimicrobials Children ... 

Is antimicrobial treatment warranted in bacterial sinusitis Since most studies have not used sinus aspiration to diagnose bacterial sinusitis, many patients with viral infections likely have diluted the results of studies of antimicrobial therapy. It is recommended that patients with mild acute sinusitis can be given decongestants and reassurance, whereas those with moderate to severe disease for 7 days or more and those with severe disease should be given antimicrobial therapy. 

Duration of therapy for treatment of sinusitis is not weU established. Most trials have used 10- to 14-day antimicrobial courses, although some trials also have investigated courses as short as 3 days. ° In one placebo-controlled comparision of 3- versus 10-day treatment with trimethoprim-sulfamethoxazole and decongestant, a... 

O Brien KL, Dowell SE, Schwartz B, et al. Acute sinusitis Principles of judicious use of antimicrobial agents. Pediatrics 1998 101(suppl) 174-77. 

Sinus and Allergy Health Partnership. Antimicrobial treatment guidelines for acute bacterial rhinosinusitis. Otolaryngol Head NeckSurg Suppl 2000 123 81-32. 

Erythromycin is a macrolide antibiotic widely used for the treatment of upper and lower respiratory tract infections. Recent reports further showed that EM and its analogues are effective for the treatment of chronic airway diseases such as DPB, bronchial asthma, and chronic sinusitis [5, 15, 32]. This effectiveness is considered to be apart from their antimicrobial actions, because they are effective at half of the recommended dosage and even in cases without concomitant infection. Its precise mechanisms, however, remain unclear. Several cytokines including IL-1, TNF-a, and IL-8 have been reported to be elevated in HALF from patients with such airway inflammatory diseases (Table II), and to be decreased... 

Aspergillosis is the most common, often associated with an environmental factor (exposure to dusts). Spore inhalation is the main route by which As-pergillus infections are contracted. This fungus affects the lungs, the sinuses, and the peripheral and central nervous systems. The prognosis is usually poor, despite the availability of appropriate antimicrobial agents (amphotericin B, itraconazole, voriconazole). 

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