Infections after endoscopic polypectomy using nasal steroids

Abstract

Background Topical nasal steroids such as beclomethasone dipropionate and fluticasone propionate have been widely used in the treatment of rhinitis and polyposis. An increase in infection has occurred with the use of fluticasone propionate after endoscopic polypectomy. Objective The purpose of this study was to determine the prevalence of nasal and paranasal infections with the use of topic nasal steroids after endoscopic polypectomy and to compare the recurrence rates of the polyposis. Design and setting We conducted a prospective, comparative, open, experimental, longitudinal study at an academic tertiary referral medical center. Methods One hundred sixty-two patients in whom endoscopic polypectomy had been indicated were randomly divided into 3 groups of 54 patients each. The patients from the first group were treated with saline lavage only. Patients from the second group also received fluticasone propionate 400 μg/day in nasal spray after lavage. Patients from the third group received beclomethasone dipropionate 600 μg/day after lavage. The prevalence of infections and recurrence of polyposis was compared in the 3 groups. Results Three patients, 2 in the placebo group and 1 in the beclomethasone group, developed infections during the first 3 months after surgical procedure. The recurrence of polyps in the group without steroids was 44%. In contrast, 15% from the patients treated with fluticasone showed recurrence of polyposis; furthermore, 26% of the patients treated with beclomethasone showed recurrence of polypsosis, with a minimum follow-up of 12 months. Conclusions The use of nasal steroids does not seem to increase the prevalence of infections after endoscopic polypectomy.