of Various Anti-Microbials in Patients of Acute Rhinosinusitis at Tertiary-Care Hospital in Uttarakhand (UK)
Oleh : Wenty Arbayeni
Pembimbing : dr. Fauziah Henny Sp.THT-KL Anatomy of Nasal Anatomy of Sinuses Introduction Needed to know that in international literature, sinusitis often called by rhinosinusitis. Because of nasal mucosa not separated with mucosa in sinus paranasalis which is if there is inflamation within sinus always be followed with inflamation in nasal conca Acute Rhinosinusitis is inflamation in nasal mucosa and sinus paranasal happen not to longger than 4 weeks. It can be caused by various inciting factors including allergens, environmental irritants, and infection by viruses, bacteria, or fungi Antibiotics were for 81% of adults with acute rhinosinusitis despite the fact that approximately 70% of patients improve spontaneously in placebo This journal to compare the efficacy and safety of gatilfloxacin, azithromycin, amoxicilin in patients of acute rhinosinusitis.
Study Design : An open randomized trial of
comparative the efficacy and safety of gatilfloxacin, azithromycin, amoxicilin in patients of acute rhinosinusitis.
Subject : Adults patients at HIMS during the
course of 1 year with primary diagnosis of clinicaly and and radiologically documented acute sinusistis of less then or equal to 4 weeks enrolled with us. Inclusion Criteria : With symptoms for more than 1 week or those with severe symptoms of rhinosinusitis. 1. Nasal discharge 2. Facial pain is not related to trauma 3. Unilateral upper jaw pain 4. Toothache in the upper jaw or pain when chewing. 5. Unilateral pain in the upper and lower jaws of the eyes when bent forward. Exclusion Criteria : 1. Patients with chronic symptoms (> 1 month) 2. Patients with immunocompromised 3. Patients with previous history of sinus surgery. 4. Pasein with previous antibiotic usage history for 1 week. 5. Comorbidity (diabetes, heart failure, immuno deficiency) 6. Pregnancy / breastfeeding mother. 7. The last anyibiotic intake for less than 4 weeks. 8. Other nose abnormalities (rice polyps) 9. Along with bronchitis, the current episode is more than 3 months old. 10. Known to have hypersensitivity in amoxicillin, macrolide, and fluroquinolone. 11. Hepatic, renal and immunological disorders. 12. Coagulation abnormalities 13. Seizures or other conditions that require therapy in the form of tranquilizers. 14. Patients who require either nasal or systemic steroids. Study Protocol Baseline Characteristic Diagnostic Criteria Based on presence of at least two major diagnostic factors or one major and two minor factors Antimicrobial therapy and Assessment Patients were recruited to study protocol and randomizid into three groups ( of ten patient each) as under : Group 1 : Patients on oral amoxicilin 500mg TDS for 10 days Group 2 : Patients on oral azithromycin 500mg OD for 5 days Group 3 : Patients on oral gatifloxacin 400mg OD for 10 days Evaluation of Efficacy Efficacy evaluation included assesment of clinical signs and symptoms, overall clinical response rating and radiographic findings waters view before and after drug treatment as primary end point and after 28 days as secondary end point. Observation and Result Conclusions Gatifloxacin was found to be most effective drug both in term of improvement in signs and symptom on visual analogue scale and radiographic scoring. It was associated with least adverse events in comparison to rest of three drugs under study. Azithromycin was the second safest drug associated with less adverse effects. Thank You