Appropriate medical management of chronic rhinosinusitis reduces use of antibiotics and oral corticosteroids
Objectives/Hypothesis Antibiotics and oral corticosteroids are used in the treatment of acute exacerbations of chronic rhinosinusitis (AECRS) and reflect poor disease control. We sought to characterize utilization of these systemic medications after appropriate medical management of chronic rhinosin...
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| Veröffentlicht in: | The Laryngoscope 2020-12, Vol.130 (12), p.E709-E714 |
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| container_issue | 12 |
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| container_title | The Laryngoscope |
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| creator | Speth, Marlene M. Phillips, Katie M. Hoehle, Lloyd P. Caradonna, David S. Gray, Stacey T. Sedaghat, Ahmad R. |
| description | Objectives/Hypothesis
Antibiotics and oral corticosteroids are used in the treatment of acute exacerbations of chronic rhinosinusitis (AECRS) and reflect poor disease control. We sought to characterize utilization of these systemic medications after appropriate medical management of chronic rhinosinusitis (CRS).
Study Design
Prospective observational study.
Methods
One hundred fifty patients undergoing medical management for CRS were studied. Data were collected at enrollment and follow‐up 3 to 12 months later. All patients were asked to report the number of CRS‐related antibiotics and oral corticosteroids used in the last 3 months. CRS symptom burden was measured using the 22‐item Sino‐Nasal Outcome Test (SNOT‐22). Associations were sought between CRS‐related antibiotics and oral corticosteroids use at follow‐up compared to enrollment.
Results
From enrollment to follow‐up, the mean number of CRS‐related antibiotics courses used decreased by 0.2 courses (95% confidence interval [CI]: 0.1–0.4, P = .012), and the mean number of CRS‐related oral corticosteroid courses used also decreased by 0.2 courses (95% CI: 0.1–0.3, P = .029). The number of CRS‐related antibiotics used at follow‐up was associated with CRS‐related antibiotic use at enrollment (adjusted rate ratio [RR] = 1.58, 95% CI: 1.17–2.13, P = .003). The number of CRS‐related oral corticosteroids used at follow‐up was associated with reported CRS‐related oral corticosteroid use at enrollment (adjusted RR = 3.20, 95% CI: 1.69–6.07, P |
| doi_str_mv | 10.1002/lary.28390 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2327931227</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2327931227</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3570-57be916ca64a4061aaf6fa6e9491f420972ded2f12bc123f34e18b8e2986adb93</originalsourceid><addsrcrecordid>eNp9kU1LxDAURYMozji68QdIwY0IHfPRps1yGPyCAUEUdBXS9NWJtM2YtMj8e1M7unDhKo_kcHk5F6FTgucEY3pVK7ed05wJvIemJGUkToRI99E0PLI4T-nLBB15_44xyViKD9GEkTzhWNApqhebjbMbZ1QHUQOl0aqOGtWqN2ig7SJbRXrtbGt05Namtd60vTed8ZGDstfgo97DQKm2M4WxndE-zGVkXQjS1oUL6ztw1pT-GB1UqvZwsjtn6Pnm-ml5F68ebu-Xi1WsWZrhOM0KEIRrxROVYE6UqnilOIhEkCqhWGS0hJJWhBaaUFaxBEhe5EBFzlVZCDZDF2Nu-NpHD76TjfEa6lq1YHsvKaOZYITSLKDnf9B327s2bCfpoIiLnPBAXY6UdtZ7B5UMxpqgXRIshw7k0IH87iDAZ7vIvghGf9Ef6QEgI_Bpatj-EyVXi8fXMfQLb3aTdg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2460969816</pqid></control><display><type>article</type><title>Appropriate medical management of chronic rhinosinusitis reduces use of antibiotics and oral corticosteroids</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Speth, Marlene M. ; Phillips, Katie M. ; Hoehle, Lloyd P. ; Caradonna, David S. ; Gray, Stacey T. ; Sedaghat, Ahmad R.</creator><creatorcontrib>Speth, Marlene M. ; Phillips, Katie M. ; Hoehle, Lloyd P. ; Caradonna, David S. ; Gray, Stacey T. ; Sedaghat, Ahmad R.</creatorcontrib><description>Objectives/Hypothesis
Antibiotics and oral corticosteroids are used in the treatment of acute exacerbations of chronic rhinosinusitis (AECRS) and reflect poor disease control. We sought to characterize utilization of these systemic medications after appropriate medical management of chronic rhinosinusitis (CRS).
Study Design
Prospective observational study.
Methods
One hundred fifty patients undergoing medical management for CRS were studied. Data were collected at enrollment and follow‐up 3 to 12 months later. All patients were asked to report the number of CRS‐related antibiotics and oral corticosteroids used in the last 3 months. CRS symptom burden was measured using the 22‐item Sino‐Nasal Outcome Test (SNOT‐22). Associations were sought between CRS‐related antibiotics and oral corticosteroids use at follow‐up compared to enrollment.
Results
From enrollment to follow‐up, the mean number of CRS‐related antibiotics courses used decreased by 0.2 courses (95% confidence interval [CI]: 0.1–0.4, P = .012), and the mean number of CRS‐related oral corticosteroid courses used also decreased by 0.2 courses (95% CI: 0.1–0.3, P = .029). The number of CRS‐related antibiotics used at follow‐up was associated with CRS‐related antibiotic use at enrollment (adjusted rate ratio [RR] = 1.58, 95% CI: 1.17–2.13, P = .003). The number of CRS‐related oral corticosteroids used at follow‐up was associated with reported CRS‐related oral corticosteroid use at enrollment (adjusted RR = 3.20, 95% CI: 1.69–6.07, P < .001). SNOT‐22 results at enrollment were also not predictive of future systemic medication use.
Conclusions
Appropriate medical management of CRS is associated with decreased use of oral antibiotics and corticosteroids. Previous utilization of antibiotics and oral corticosteroids for CRS is associated with future use of these medications.
Level of Evidence
2c Laryngoscope, 2019</description><identifier>ISSN: 0023-852X</identifier><identifier>EISSN: 1531-4995</identifier><identifier>DOI: 10.1002/lary.28390</identifier><identifier>PMID: 31846092</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>acute exacerbations ; Administration, Oral ; Adrenal Cortex Hormones - therapeutic use ; Anti-Bacterial Agents - therapeutic use ; Antibiotics ; Chronic Disease ; Chronic rhinosinusitis ; corticosteroids ; disease control ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Rhinitis ; Rhinitis - drug therapy ; Sinusitis ; Sinusitis - drug therapy</subject><ispartof>The Laryngoscope, 2020-12, Vol.130 (12), p.E709-E714</ispartof><rights>2019 The American Laryngological, Rhinological and Otological Society, Inc.</rights><rights>2020 The American Laryngological, Rhinological and Otological Society, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3570-57be916ca64a4061aaf6fa6e9491f420972ded2f12bc123f34e18b8e2986adb93</citedby><cites>FETCH-LOGICAL-c3570-57be916ca64a4061aaf6fa6e9491f420972ded2f12bc123f34e18b8e2986adb93</cites><orcidid>0000-0001-6304-3508 ; 0000-0001-6331-2325</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Flary.28390$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Flary.28390$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31846092$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Speth, Marlene M.</creatorcontrib><creatorcontrib>Phillips, Katie M.</creatorcontrib><creatorcontrib>Hoehle, Lloyd P.</creatorcontrib><creatorcontrib>Caradonna, David S.</creatorcontrib><creatorcontrib>Gray, Stacey T.</creatorcontrib><creatorcontrib>Sedaghat, Ahmad R.</creatorcontrib><title>Appropriate medical management of chronic rhinosinusitis reduces use of antibiotics and oral corticosteroids</title><title>The Laryngoscope</title><addtitle>Laryngoscope</addtitle><description>Objectives/Hypothesis
Antibiotics and oral corticosteroids are used in the treatment of acute exacerbations of chronic rhinosinusitis (AECRS) and reflect poor disease control. We sought to characterize utilization of these systemic medications after appropriate medical management of chronic rhinosinusitis (CRS).
Study Design
Prospective observational study.
Methods
One hundred fifty patients undergoing medical management for CRS were studied. Data were collected at enrollment and follow‐up 3 to 12 months later. All patients were asked to report the number of CRS‐related antibiotics and oral corticosteroids used in the last 3 months. CRS symptom burden was measured using the 22‐item Sino‐Nasal Outcome Test (SNOT‐22). Associations were sought between CRS‐related antibiotics and oral corticosteroids use at follow‐up compared to enrollment.
Results
From enrollment to follow‐up, the mean number of CRS‐related antibiotics courses used decreased by 0.2 courses (95% confidence interval [CI]: 0.1–0.4, P = .012), and the mean number of CRS‐related oral corticosteroid courses used also decreased by 0.2 courses (95% CI: 0.1–0.3, P = .029). The number of CRS‐related antibiotics used at follow‐up was associated with CRS‐related antibiotic use at enrollment (adjusted rate ratio [RR] = 1.58, 95% CI: 1.17–2.13, P = .003). The number of CRS‐related oral corticosteroids used at follow‐up was associated with reported CRS‐related oral corticosteroid use at enrollment (adjusted RR = 3.20, 95% CI: 1.69–6.07, P < .001). SNOT‐22 results at enrollment were also not predictive of future systemic medication use.
Conclusions
Appropriate medical management of CRS is associated with decreased use of oral antibiotics and corticosteroids. Previous utilization of antibiotics and oral corticosteroids for CRS is associated with future use of these medications.
Level of Evidence
2c Laryngoscope, 2019</description><subject>acute exacerbations</subject><subject>Administration, Oral</subject><subject>Adrenal Cortex Hormones - therapeutic use</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antibiotics</subject><subject>Chronic Disease</subject><subject>Chronic rhinosinusitis</subject><subject>corticosteroids</subject><subject>disease control</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><subject>Rhinitis</subject><subject>Rhinitis - drug therapy</subject><subject>Sinusitis</subject><subject>Sinusitis - drug therapy</subject><issn>0023-852X</issn><issn>1531-4995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU1LxDAURYMozji68QdIwY0IHfPRps1yGPyCAUEUdBXS9NWJtM2YtMj8e1M7unDhKo_kcHk5F6FTgucEY3pVK7ed05wJvIemJGUkToRI99E0PLI4T-nLBB15_44xyViKD9GEkTzhWNApqhebjbMbZ1QHUQOl0aqOGtWqN2ig7SJbRXrtbGt05Namtd60vTed8ZGDstfgo97DQKm2M4WxndE-zGVkXQjS1oUL6ztw1pT-GB1UqvZwsjtn6Pnm-ml5F68ebu-Xi1WsWZrhOM0KEIRrxROVYE6UqnilOIhEkCqhWGS0hJJWhBaaUFaxBEhe5EBFzlVZCDZDF2Nu-NpHD76TjfEa6lq1YHsvKaOZYITSLKDnf9B327s2bCfpoIiLnPBAXY6UdtZ7B5UMxpqgXRIshw7k0IH87iDAZ7vIvghGf9Ef6QEgI_Bpatj-EyVXi8fXMfQLb3aTdg</recordid><startdate>202012</startdate><enddate>202012</enddate><creator>Speth, Marlene M.</creator><creator>Phillips, Katie M.</creator><creator>Hoehle, Lloyd P.</creator><creator>Caradonna, David S.</creator><creator>Gray, Stacey T.</creator><creator>Sedaghat, Ahmad R.</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6304-3508</orcidid><orcidid>https://orcid.org/0000-0001-6331-2325</orcidid></search><sort><creationdate>202012</creationdate><title>Appropriate medical management of chronic rhinosinusitis reduces use of antibiotics and oral corticosteroids</title><author>Speth, Marlene M. ; Phillips, Katie M. ; Hoehle, Lloyd P. ; Caradonna, David S. ; Gray, Stacey T. ; Sedaghat, Ahmad R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3570-57be916ca64a4061aaf6fa6e9491f420972ded2f12bc123f34e18b8e2986adb93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>acute exacerbations</topic><topic>Administration, Oral</topic><topic>Adrenal Cortex Hormones - therapeutic use</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Antibiotics</topic><topic>Chronic Disease</topic><topic>Chronic rhinosinusitis</topic><topic>corticosteroids</topic><topic>disease control</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prospective Studies</topic><topic>Rhinitis</topic><topic>Rhinitis - drug therapy</topic><topic>Sinusitis</topic><topic>Sinusitis - drug therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Speth, Marlene M.</creatorcontrib><creatorcontrib>Phillips, Katie M.</creatorcontrib><creatorcontrib>Hoehle, Lloyd P.</creatorcontrib><creatorcontrib>Caradonna, David S.</creatorcontrib><creatorcontrib>Gray, Stacey T.</creatorcontrib><creatorcontrib>Sedaghat, Ahmad R.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The Laryngoscope</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Speth, Marlene M.</au><au>Phillips, Katie M.</au><au>Hoehle, Lloyd P.</au><au>Caradonna, David S.</au><au>Gray, Stacey T.</au><au>Sedaghat, Ahmad R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Appropriate medical management of chronic rhinosinusitis reduces use of antibiotics and oral corticosteroids</atitle><jtitle>The Laryngoscope</jtitle><addtitle>Laryngoscope</addtitle><date>2020-12</date><risdate>2020</risdate><volume>130</volume><issue>12</issue><spage>E709</spage><epage>E714</epage><pages>E709-E714</pages><issn>0023-852X</issn><eissn>1531-4995</eissn><abstract>Objectives/Hypothesis
Antibiotics and oral corticosteroids are used in the treatment of acute exacerbations of chronic rhinosinusitis (AECRS) and reflect poor disease control. We sought to characterize utilization of these systemic medications after appropriate medical management of chronic rhinosinusitis (CRS).
Study Design
Prospective observational study.
Methods
One hundred fifty patients undergoing medical management for CRS were studied. Data were collected at enrollment and follow‐up 3 to 12 months later. All patients were asked to report the number of CRS‐related antibiotics and oral corticosteroids used in the last 3 months. CRS symptom burden was measured using the 22‐item Sino‐Nasal Outcome Test (SNOT‐22). Associations were sought between CRS‐related antibiotics and oral corticosteroids use at follow‐up compared to enrollment.
Results
From enrollment to follow‐up, the mean number of CRS‐related antibiotics courses used decreased by 0.2 courses (95% confidence interval [CI]: 0.1–0.4, P = .012), and the mean number of CRS‐related oral corticosteroid courses used also decreased by 0.2 courses (95% CI: 0.1–0.3, P = .029). The number of CRS‐related antibiotics used at follow‐up was associated with CRS‐related antibiotic use at enrollment (adjusted rate ratio [RR] = 1.58, 95% CI: 1.17–2.13, P = .003). The number of CRS‐related oral corticosteroids used at follow‐up was associated with reported CRS‐related oral corticosteroid use at enrollment (adjusted RR = 3.20, 95% CI: 1.69–6.07, P < .001). SNOT‐22 results at enrollment were also not predictive of future systemic medication use.
Conclusions
Appropriate medical management of CRS is associated with decreased use of oral antibiotics and corticosteroids. Previous utilization of antibiotics and oral corticosteroids for CRS is associated with future use of these medications.
Level of Evidence
2c Laryngoscope, 2019</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>31846092</pmid><doi>10.1002/lary.28390</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0001-6304-3508</orcidid><orcidid>https://orcid.org/0000-0001-6331-2325</orcidid></addata></record> |
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| ispartof | The Laryngoscope, 2020-12, Vol.130 (12), p.E709-E714 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | acute exacerbations Administration, Oral Adrenal Cortex Hormones - therapeutic use Anti-Bacterial Agents - therapeutic use Antibiotics Chronic Disease Chronic rhinosinusitis corticosteroids disease control Female Humans Male Middle Aged Prospective Studies Rhinitis Rhinitis - drug therapy Sinusitis Sinusitis - drug therapy |
| title | Appropriate medical management of chronic rhinosinusitis reduces use of antibiotics and oral corticosteroids |
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