Risk of Becoming Resistant to Antibiotics May Be Lower Than Expected for Chronic Sinus Infection Sufferers
Study suggests use of targeted treatment may help prevent antibiotic resistance, a major public health concern
BOSTON - Patients suffering from debilitating and painful chronic sinus infections who are often concerned about developing resistance to the antibiotics they rely on for symptom relief may now have one less thing to worry about. Researchers from Brigham and Women’s Hospital (BWH) have shown that patients with chronic sinus infections do not appear to develop individual resistance to antibiotics when diagnosed and treated using a targeted approach. These findings will be published in the October 2004 issue of The Archives of Otolaryngology-Head & Neck Surgery.
Antibiotic resistance has emerged as a major public health threat, prompting leading groups such as the Centers for Disease Control and the Food and Drug Administration to launch a national campaign to reduce excessive prescribing and over-use of antibiotics.
"Because sinus infections are so prevalent and it is the fifth most common diagnosis for which antibiotics are prescribed, our patients are a key area of concern," said Neil Bhattacharyya, MD, an otolaryngologist at BWH and lead author. "This study was designed to help determine how great a risk antibiotic resistance was among chronic sinus patients to determine if there is a need to re-evaluate how we diagnose and treat the condition. Interestingly, our research shows that patients suffering from chronic sinus infections may be able to lower their rate and likelihood of antibiotic resistance if a careful and strict approach to care is followed.
According to the Sinus and Allergy Health Partnership (SAHP), approximately 31 million Americans are believed to have a sinus infection each year with approximately 20 million Americans experiencing a chronic problem, also known as chronic sinusitis (CRS) at some point during their lifetime. Sinusitis is more prevalent than arthritis and hypertension and, when chronic, sinusitis can be as equally debilitating as diabetes and chronic heart disease.
In this study, Bhattacharyya and co-author, Lynn J. Kepnes, RNP, followed 90 CRS patients over a seven-year period. Bacteria cultures were obtained so that the researchers could measure changes in each patient’s level of antibiotic resistance over the course of their treatment. They found no statistically significant increase in levels of bacteria-resistant organisms in the samples they collected.
Importantly, the majority of patients studied underwent culture-directed therapy, meaning a minimally invasive procedure was done to first confirm that the infection was indeed caused by a bacteria and secondly, to identify the specific type of bacteria so that a targeted antibiotic could be prescribed rather than a general one.
"The fact that the patients in our study did not develop antibiotic resistance suggests culture-directed therapy may be an approach that helps keep patients at relatively low risk," said Bhattacharyya who is also an associate professor of Otology and Laryngology at Harvard Medical School. "Given the debate surrounding proper treatment of this population in general, our findings add more evidence that antibiotics should be used, as long as they are used carefully and this begins with procedures that help guide accurate prescribing. Patients should continue to be mindful, however, that the potential risk of antibiotic resistance always exists whenever these medications are used excessively."
Please contact BWH Media Relations for more information at (617) 534-1600 or BWHMediaRelations@partners.org
Brigham and Women's Hospital is a 747-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare System, an integrated health care delivery network. BWH is committed to excellence in patient care with expertise in virtually every specialty of medicine and surgery. The BWH medical preeminence dates back to 1832 and today that rich history in clinical care is coupled with its national leadership in quality improvement and patient safety initiatives, dedication to educating and training health care professionals, and strength in biomedical research. With $370M in funding and more than 500 research scientists, BWH is an acclaimed leader in clinical, basic and epidemiological investigation - including the landmark Nurses Health Study, Physicians Health Studies, and the Women's Health Initiative. For more information about BWH, please visit: www.brighamandwomens.org.
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