Abstract
Background: Antibiotics have been used routinely for postoperative care in patients with chronic rhinosinusitis (CRS). However, increased bacterial growth was found after antibiotic treatment. In traditional Chinese medicine, Jia Wei Cang Er San has been used to treat CRS. This study was to investigate the influence of Jia Wei Cang Er San on the postoperative bacteriology of CRS. Methods: Ninety-seven CRS patients who underwent functional endoscopic sinus surgery (FESS) were included. They were randomly divided into 3 groups. In the group of Chinese herbal medicine (CHM), patients were given a capsule of Jia Wei Cang Er San tid for 8 weeks and a placebo capsule for amoxicillin q8h for 4 weeks after FESS. In the amoxicillin group, patients were given a capsule of amoxicillin 250 mg q8h for 4 weeks and a placebo capsule for Jia Wei Cang Er San tid for 8 weeks. In the placebo group, patients were given both placebo capsules. Bacterial cultures were performed from bilateral middle meati before FESS, and 8 and 12 weeks after FESS. Results: In the CHM group, bacteria grew in 21 (46%) of 46 specimens pre-operatively, in 23 (50%) specimens 8 weeks and in 17 (37%) specimens 12 weeks after surgery. In the amoxicillin group, bacteria grew in 15 (28%) of 54 specimens pre-operatively, in 30 (56%) specimens 8 weeks and in 32 (59%) specimens 12 weeks after surgery. In the placebo group, bacteria were found in 13 (34%) of 38 specimens pre-operatively, in 16 (42%) specimens 8 weeks and in 12 (32%) specimens 12 weeks after surgery. The rates of bacterial growth did not change by Jia Wei Cang Er San 8 or 12 weeks after surgery, but increased significantly by amoxicillin 8 and 12 weeks after surgery. Conclusion: Our study showed that Jia Wei Cang Er San did not induce bacterial growth after FESS as amoxicillin.
Highlights
Functional endoscopic sinus surgery (FESS) has become a standard surgical modality for treating chronic rhinosinusitis (CRS) [1]
Patients were given a capsule of amoxicillin 250 mg q8h for 4 weeks and a placebo capsule for Jia Wei Cang Er San tid for 8 weeks
Jia Wei Cang Er San which is one of most common used Chinese herbal medicines (CHM) to treat rhinosinusitis in Taiwan has been reported to alleviate the nasal symptoms of allergic rhinitis by way of its inhibitory effect on type I anaphylaxis reactions and eosinophil infiltration in the nasal tissues as well as the inhibition of some mediators related to allergic rhinitis [5,6]
Summary
Functional endoscopic sinus surgery (FESS) has become a standard surgical modality for treating chronic rhinosinusitis (CRS) [1]. One of its active components, Angelica dahurica, has been shown to possess antibiotic and cyclooxygenase-2 inhibitory activities and is used to treat rhinosinusitis [7] When both antibiotics and CHM were commonly used to treat CRS in Taiwan, we tried to compare the influence of Jia Wei Cang Er San with amoxicillin on the post-FESS bacteriology in CRS patients. Methods: Ninety-seven CRS patients who underwent functional endoscopic sinus surgery (FESS) were included. They were randomly divided into 3 groups. In the group of Chinese herbal medicine (CHM), patients were given a capsule of Jia Wei Cang Er San tid for 8 weeks and a placebo capsule for amoxicillin q8h for 4 weeks after FESS. Conclusion: Our study showed that Jia Wei Cang Er San did not induce bacterial growth after FESS as amoxicillin
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