Медицинский совет (May 2021)
Rational topical treatment of uncomplicated rhinosinusitis as a basis for successful recovery
Abstract
The article is devoted to the treatment of one of the most common diseases - the treatment of rhinosinusitis. According to statistics only 2% of the sinusitis in population are bacterial. At the same time administration of systemic antibiotic therapy reaches 95.5%. The problem of rational prescription of antibacterial drugs, including management of the rhinosinusitis, is very acute, especially considering the constant increase in the number of antibiotic-resistant microorganisms. Currently, the level of patients with prolonged post-viral rhinosinusitis after COVID-19 has increased. Most have a history of one or more courses of systemic antibiotics and, often, without indications. In article are listed indications for systemic and local antibacterial therapy in adults and children, based on national and European clinical guidelines. The data on complications during the use of systemic antibacterial drugs are presented. Authors give information about the advantages of the local use of antibiotics: the absence of general toxic complications, the creation of an optimal concentration directly in the focus of inflammation. The advantages of combining solutions of neomycin and polymyxin B for topical use, such as a pronounced bactericidal effect against gram-positive and gram-negative bacteria (Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Haemophilus influenzae, Pseudomonas aeruginosa), causing the development of infectious processes in the upper respiratory tract, are separately noted. The author describes his own experience of using the original nasal spray Polydex with phenylephrine, containing a fixed combination of neomycin, polymyxin B, dexamethasone sodium metasulfobenzoate and phenylephrine, in the treatment of patients with post-viral rhinosinusitis. As a result of the collection of literature data, as well as based on their own experience, the authors concluded that the use of this nasal spray in outpatient practice will significantly improve the effectiveness of treatment and reduce the frequency of prescribing systemic antibiotics.
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