Treatment Of Bacterial Sinusitis Research Articles

The effectiveness of a polyvalent antigenic complex including bacterial lysates in the treatment and prevention of rhinosinusitis against the background of acute respiratory viral infections and COVID-19 (clinical description)

One of the urgent tasks of the Ministry of Health of the Russian Federation, noted in the State report on the state of sanitary and epidemiological welfare of the population, is the improvement and implementation of diagnostic and treatment and prevention technologies. First of all, this concerns the continued growth of respiratory viral infections, seasonal influenza epidemics, where SARS-CoV-2 coronavirus infection occupies a special place, which often cause various otorhinolaryngological complications – acute and exacerbations of chronic tonsillopharyngitis, rhinosinusitis, tubotitis, purulent otitis media. In the treatment of bacterial sinusitis, in accordance with clinical recommendations, intranasal corticosteroids, elimination therapy, herbal remedies, and antibacterial drugs are used. Due to the period of the SARS-CoV-2 pandemic, a significant proportion of patients took large doses of antibacterial drugs, which caused an increase in the resistance of microorganisms to them. In this regard, it is possible to use immunostimulating drugs that stimulate cellular and humoral immunity, promote the development of a specific immune response and activate nonspecific defense factors such as lysozyme, mucin, lactoferrin and normalize mucociliary clearance. As a rule, the identification of a viral agent is carried out in case of a severe clinical course of the disease or complications from the ORL and other organs, and the use of immunostimulating agents in complex therapy is necessary at the earliest possible time of the disease. In this context, the use of immunostimulants containing polyvalent antigenic complexes, including bacterial lysates, the most common pathogens of respiratory infections, is justified. It is preferable in these cases to use lysates of bacteria obtained by mechanical destruction of bacterial cells, since they have a more pronounced non-specific immunostimulatory and specific vaccinating effect.

Invasive pseudomembranous upper airway and tracheal Aspergillosis refractory to systemic antifungal therapy and serial surgical debridement in an Immunocompetent patient

BackgroundThe development of respiratory infections secondary to Aspergillus spp. spores found ubiquitously in the ambient environment is uncommon in immunocompetent patients. Previous reports of invasive upper airway aspergillosis in immunocompetent patients have generally demonstrated the efficacy of treatment regimens utilizing antifungal agents in combination with periodic endoscopic debridement, with symptoms typically resolving within months of initiating therapy.Case presentationA 43-year-old previously healthy female presented with worsening respiratory symptoms after failing to respond to long-term antibiotic treatment of bacterial sinusitis. Biopsy of her nasopharynx and trachea revealed extensive fungal infiltration and Aspergillus fumigatus was isolated on tissue culture. Several months of oral voriconazole monotherapy failed to resolve her symptoms and she underwent mechanical debridement for symptom control. Following transient improvement, her symptoms subsequently returned and failed to fully resolve in spite of increased voriconazole dosing and multiple additional tissue debridements over the course of many years.ConclusionsInvasive upper airway aspergillosis is exceedingly uncommon in immunocompetent patients. In the rare instances that such infections do occur, combinatorial voriconazole and endoscopic debridement is typically an efficacious treatment approach. However, some patients may continue to experience refractory symptoms. In such cases, continued aggressive treatment may potentially slow disease progression even if complete disease resolution cannot be achieved.

Comparative efficacy and safety of clarithromycin in the treatment of bacterial sinusitis

Comparative efficacy and safety of clarithromycin in the treatment of bacterial sinusitis

Pseudo-uvéite sévère associée à l’utilisation de moxifloxacine

Moxifloxacin is an antibiotic of the fluoroquinolone class, marketed in France since 2002. It is used primarily in the treatment of bacterial sinusitis and acute exacerbations of chronic bronchitis. The purpose of this study is to report a possible severe ocular side effect following the systemic use of moxifloxacin. Case report of a patient who presented with the appearance of a severe acute uveitis after being treated with systemic moxifloxacin. Eleven days after initiation of moxifloxacin treatment, the patient developed simultaneous bilateral eye pain, pigment dispersion and diffuse iris transillumination. This case was further complicated by ocular hypertension. Etiologic investigations for other causes of the uveitis were negative. In particular, an anterior chamber tap was performed and PCR for herpes viruses (HSV, VZV, EBV, CMV) was negative. Drug-induced uveitis is relatively rare. The relationship between systemic fluoroquinolone treatment and the occurrence of uveitis has been considered "possible", according to World Health Organization criteria, in a recent retrospective analysis of 40 case reports. Moxifloxacin was suspected in 25 of these cases. The presence of both iris transillumination and pigment dispersion appears specific to the uveitis in question. It appears that practitioners prescribing moxifloxacin and ophthalmologists should be informed of this possible adverse effect, so that it may be quickly recognized, managed and reported.