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https://hdl.handle.net/2440/73826
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Type: | Journal article |
Title: | A randomized trial of mupirocin sinonasal rinses versus saline in surgically recalcitrant staphylococcal chronic rhinosinusitis |
Author: | Jervis-Bardy, J. Boase, S. Psaltis, A. Foreman, A. Wormald, P. |
Citation: | The Laryngoscope, 2012; 122(10):2148-2153 |
Publisher: | Lippincott Williams & Wilkins |
Issue Date: | 2012 |
ISSN: | 0023-852X 1531-4995 |
Statement of Responsibility: | Joshua Jervis-Bardy, Samuel Boase, Alkis Psaltis, Andrew Foreman and Peter-John Wormald |
Abstract: | OBJECTIVES/HYPOTHESIS: Chronic rhinosinusitis (CRS) recalcitrant to surgery is a frustrating clinical entity. Recently, mupirocin sinonasal rinses have been suggested as an efficacious treatment alternative in these patients where Staphylococuccus aureus infection is demonstrated. To our knowledge, how best to treat this S aureus reservoir has not been previously evaluated in a double-blinded, randomized, placebo-controlled trial. STUDY DESIGN: Prospective, double-blinded, placebo-controlled study. METHODS: Twenty-five S aureus-positive CRS patients with persistent sinonasal infection despite endoscopic sinus surgery received either a 1-month, twice-daily treatment course of mupirocin sinonasal rinses (MUP) or saline rinses (CON). The primary outcome was S aureus-culture negativity at the conclusion of treatment; secondary rhinological outcomes included subjective and objective measures of rhinosinusitis. RESULTS: Twenty-two patients satisfactorily completed the treatment period. Of CON patients, 0/13 (0.0%) returned an S aureus-negative sinonasal culture at 1month, compared to 8/9 (88.9%) of MUP patients (P < .01). Improvements in rhinological outcomes observed in MUP patients following treatment were not subsequently evident when these patients were followed up at a delayed assessment 2 to 6 months after completing treatment. CONCLUSIONS: Mupirocin sinonasal rinses are an effective short-term anti-S aureus treatment in surgically recalcitrant CRS as assessed by microbiological and selected rhinological outcomes, although the latter improvements may not be durable with time. |
Keywords: | Nose Humans Staphylococcus aureus Staphylococcal Infections Sinusitis Rhinitis Chronic Disease Mupirocin Anti-Bacterial Agents Treatment Outcome Administration, Intranasal Double-Blind Method Adult Middle Aged Female Male Nasal Lavage |
Rights: | Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc. |
DOI: | 10.1002/lary.23486 |
Published version: | http://dx.doi.org/10.1002/lary.23486 |
Appears in Collections: | Aurora harvest 4 Surgery publications |
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