Медицинский совет (Nov 2017)

PLACE OF TOPICAL STEROID THERAPY IN THE TREATMENT OF ACUTE RHINOSINUSITIS

  • S. Ia. Kosyakov,
  • J. V. Minavnina

DOI
https://doi.org/10.21518/2079-701X-2017-16-18-23
Journal volume & issue
Vol. 0, no. 16
pp. 18 – 23

Abstract

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Acute rhinosinusitis is a common inflammation of the nose and paranasal sinuses. The sinusitis diagnosis is based on a combination of clinical data with examination, data of instrumental studies. Viral ARS accounts for more than 90 per cent of cases. The bacterial etiology of sinusitis occurs in around 55–65% of cases. The purpose of the treatment of the acute RS is to eliminate the focus of infection, restore the ostiomeatal complex, regulate a drainage function, reduce inflammation and alleviate symptoms such as pain and nasal congestion. The main areas of treatment are antibacterial therapy, irrigation, anti-inflammatory therapy. Topical corticosteroids – first line drugs, along with irrigation. They can be used both as monotherapy as well as in addition to antibacterial therapy. In the light forms of ARS mometazone at a dosage of 400 μg per day was much more efficient than placebo and amoxicillin. And the addition of topical corticosteroids (MF) to the standard course of system antibiotic therapy (amoxicillin/clavulanate, cefuroxime) was much faster than the placebo to facilitate the symptoms of the acute RS and accelerated recovery. Intranasal steroids help in the treatment of daytime cough. When compared to treatment by other inhalation corticosieroids mometasone has higher efficiency, safety, better resolution of symptoms, lower cost of treatment. Mometasone can be used by pregnant women without fear of systemic manifestations.

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