Treatment of chronic rhinosinusitis exacerbations

Abstract

Introduction. The prevalence of chronic rhinosinusitis, an increase in the resistance of pathogenic microorganisms, growing numbers of patients with allergic reactions to antibiotics necessitates the use of topical antibacterial therapy or the nasal cavity and paranasal sinuses, which are accessible for local remedies.Aim. Efficacy and tolerability of topical antibacterial drug hydroxymethylquinoxalindioxide in the treatment of chronic rhinosinusitis exacerbation has been investigated in our study.Materials and methods. An open non-invasive observational study of efficacy and tolerability of irrigation therapy with hydroxymethylquinoxalindioxide in 50 adult patients with exacerbation of chronic rhinosinusitis has been conducted at the Department of Otorhinolaryngology, Pavlov State Medical University (Saint Petersburg). The patients were randomized into 2 groups. In the first group, patients were treated with 40 ml of 0.25% hydroxymethylquinoxalindioxide solution nasal irrigation b.i.d. for 7 days, in the second – the same amount of normal saline was used. Duration and severity of symptoms, dynamics of nasal endoscopic picture, and the results of bacteriological study were evaluated before and after the treatment. Safety was assessed according to the data of complete blood cell count, mucociliary transport time and the incidence of adverse events.Results and discussion. In the hydroxymethylquinoxalindioxide group, there was a statistically significant improvement in the mucociliary transport time by the end of treatment from 19.1 ± 5.08 minutes to 15.2 ± 1.2 minutes (p = 0.002) compared to the normal saline group. According to the results of bacteriological study, eradication of the pathogen in the hydroxymethylquinoxalindioxide group was achieved in 85% (n = 21), comparing to only 17% (n = 4) of cases in the control group.Conclusion. Irrigation therapy with 0.25% hydroxymethylquinoxaline dioxide is more effective than saline flush solution. The drug can be recommended for irrigation therapy in adults with chronic rhinosinusitis exacerbation.