Acute bacterial rhinosinusitis. Do we always need antibiotics?

Background. Treatment of patients with acute bacterial rhinosinusitis (ABR) is an urgent and unresolved problem: there is a widespread prevalence and increase in the resistance of pathogens due to irrational, repeated courses of antibiotic therapy, especially in cases of mild rhinosinusitis. In this regard, it seems relevant to study the possibilities of alternative treatment, without the use of antibiotics. Objective. Evaluation of the effectiveness of monotherapy with Sinuforte in the treatment of patients with mild acute rhinosinusitis. Methods. The study included 85 patients (49 women, 36 men) aged 18 to 56 years (mean age 34.5±6.2 years) with a diagnosis of mild ABR, confirmed by clinical and anamnestic data and laboratory and instrumental research methods. Depending on the tactics of treatment, the patients were randomized into 2 groups. In the main group, the treatment regimen included the use of Sinuforte, 1 dose (1.3 mg) once a day as an intranasal spray for 7 days. In the comparison group, patients used only irrigation of the nasal cavity in combination with decongestants for 7 days. The effectiveness of the treatment was assessed on 3rd and 7th days and was determined by the degree of decrease in subjective and objective symptoms of ABR according to a 10-point system using a visual analogue scale (VAS), mucociliary clearance rate (saccharin test) and dynamics of the X-ray pattern. Results. According to the results obtained, the severity of subjective and objective symptoms of ABR presented in points on the 7th day was significantly lower in the main group. The dynamics of a decrease in the radiographic signs of rhinosinusitis and an improvement in mucociliary clearance in the main group were similar, which was expressed in the achievement of statistical significance between the groups according to these indicators by the end of the study (p<0.05). Conclusion. The results of the study confirm the high efficacy and safety of monotherapy with Sinuforte in patients with mild ABR compared to the treatment regimen using topical decongestants and irrigation therapy. Such a tactic of treatment is characterized by the absence of undesirable effects and allow to avoid the appointment of antibacterial drugs.

acute rhinosinusitis, Sinuforte, conservative treatment