Acute Bacterial Rhinosinusitis

Awareness Among Primary Care Physicians Regarding the Alarm Symptoms and Signs of Rhinosinusitis

Background Rhinosinusitis is a common condition. Primary care physicians (PCPs) play a vital role in diagnosing and managing rhinosinusitis, including identifying alarm symptoms and signs. However, limited research exists on PCPs' awareness of these alarm symptoms. Objectives This study aimed to assess the awareness of PCPs in Saudi Arabia regarding the alarm symptoms and signs of rhinosinusitis and identify knowledge gaps. Methodology A descriptive cross-sectional study was conducted among 153 PCPs in Taif, Saudi Arabia. An online questionnaire covering demographic data and multiple-choice questions on alarm symptoms and signs of rhinosinusitis was administered. Knowledge level was assessed based on the score of the responses to knowledge items. Data analysis was performed using IBM SPSS software (IBM Corp., Armonk, NY). Results The study revealed a low awareness of alarm symptoms and signs of rhinosinusitis among PCPs. Knowledge gaps were observed in recognizing symptoms and appropriate referral pathways. Participants showed inadequate awareness of severe headaches, frontal swelling, anosmia, cacosmia, and nasal bleeding or crustation as alarm symptoms. The average knowledge score was 4.57 ± 1.91 out of 10. Conclusion The study highlights the need to improve PCP awareness of alarm symptoms and signs of rhinosinusitis in Saudi Arabia. Educational programs should be developed to address knowledge gaps and enhance understanding of guidelines, facilitating early identification and referral of severe cases and improving patient outcomes.

Prevalence of Antibiotic Prescription in Patients with Acute Rhinosinusitis Treated by General Practitioners and Otolaryngologists in Germany-A Retrospective Cohort Study

(1) Background: The goal of this retrospective cohort study, based on real-world data and conducted in Germany, was to investigate the prevalence of antibiotic (AB) prescription in patients with acute rhinosinusitis (ARS). (2) Methods: Data from the Disease Analyzer database were used for this cross-sectional study. Patients aged ≥18 years diagnosed with acute sinusitis by general practitioners (GPs) and ear, nose, throat (ENT) specialists between January 2012 and December 2020 were included. The main outcome of the study was the proportion of patients with ARS who received an AB prescription on the day of diagnosis or within three days afterwards. The proportion was estimated separately for patients treated by GPs and ENTs, and also for five age groups, as well as women and men. (3) Results: In total, 308,095 patients were diagnosed with ARS (187,838 by GPs and 120,257 by ENTs). 50.9% of patients treated by GPs and 50.0% treated by ENTs received an AB prescription. AB prevalence increased with age from 46.9% in the age group 18−30 years to 55.5% in the age group > 60 years. (4) Conclusions: We have shown a high prevalence of potentially inappropriate AB prescription for adult patients with ARS in both GP and ENT practices and also among both women and men and in several age groups. There is an urgent need for interventions to reduce inappropriate AB use.

Effects of different antibiotics in the treatment of acute rhinosinusitis

Introduction: Sinusitis is an inflammation of the paranasal sinuses and it can be infectious, allergic or autoimmune. Acute rhinosinusitis commonly has viral origin and occurs as part of the upper respiratory tract infections. The most common pathogens are Streptococcus, Pneumococcus and Haemophilus influenzae. Some inflammations may start as viral, but develop into bacterial superinfection, i.e., subsequent colonization of the bacteria in 0.5-2% of cases. Viral sinusitis lasts for 7-10 days, whereas bacterial may take longer. The aim: The aim of this study was to compare three therapeutic protocols for the treatment of acute bacterial rhinosinusitis. Materials and Methods: A prospective clinical study was conducted at the Ear, Nose and Throat Clinic, Clinical Center Nis from October 2019 to January 2020, and it involved patients with acute bacterial rhinosinusitis in whom we compared the efficiency and safety of levofloxacin administration for five and 10 days with the efficiency of amoxicillin clavulanate treatment. The study included 62 patients with documented clinical and radiological symptoms. Results: Confirmation of bacterial etiology is not routinely performed in clinical practice since it requires antral puncture or endoscopic examination of the middle nasal meatus. Consequently, the choice of antibiotic therapy is empiric. In our study, we used levofloxacin for five (500 mg once a day) and 10 days (500 mg once a day) and amoxicillin-clavulanatefor 10 days (500 mg-125 mg three times a day), and the results showed no statistically significant difference in regard to the choice of antibiotics and the duration of therapy. Conclusion: The findings of this study suggest that a short course of antibiotic treatment has similar efficiency compared to a longer course of treatment of patients with uncomplicated acute bacterial sinusitis when treatment is indicated.

Prevalence and clinical presentation of sinusitis in pediatric age group in Aseer, Saudi Arabia

Background:

Paediatric rhinosinusitis is mostly different than that in adults. More frequently, children presented with cough, bad breath, crankiness, low energy, and swelling around the eyes, besides a thick yellow-green nasal or post-nasal discharge. About 5- 13% of childhood viral upper respiratory tract infections may advance to acute rhinosinusitis, with some of them developing a chronic condition.

Aim:

To assess prevalence and clinical presentation of sinusitis in the paediatric age group in Aseer, Saudi Arabia.

Methodology:

A retrospective record-based study was conducted in Abha Maternity and Children Hospital in Abha city, Saudi Arabia between January 2015 and January 2018. All medical records during the study period for children whose from to 15 years old attended the hospital and diagnosed as having sinusitis were included.

Results:

The study included 100 children with complete files whose ages ranged from less than 1 year to up to 13 years old with a mean age of 5.3 4.2 years. Nearly 51% of the children aged 4 years or less and male were 53 (53%). Past history for chronic rhinosinusitis (CRS) was positive among 30 children. Regarding clinical presentations of rhinosinusitis (RS) as reported by the children caregivers, fever was the most reported complaint (50%) followed by red eye (44%), ringing nose (42%), cough (41%) and headache (36%). Mucous culture was positive among 58 cases. The most isolated pathogens were streptococcus pneumoniae (45.6%), Haemophilis influenza (24.6%).

Conclusions:

In conclusion, the study revealed that CRS is a common disease in children at different ages, especially, maxillary and frontal sinuses. In most of the cases, medical treatment is highly appreciated; though, surgical intervention may be needed in a small percentage.