The practice of treating acute and chronic rhinosinusitis in the USA

According to medical statistics, chronic rhinosinusitis causes 14 million requests for medical care per year in the United States, acute rhinosinusitis - 3 million. A four-year prospective study by H.J. Sharp et al. (USA), was to highlight the general trends in the appointment of drugs to patients with acute and chronic rhinosinusitis. The work included data from National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey surveys, collected by the National Center for Medical Statistics in the United States..

According to the results, most often in acute and chronic rhinosinusitis, antibiotics, antihistamines, decongestants, corticosteroids, cough suppressants, expectorants and mucolytics were prescribed. Thus, 83% of cases seeking medical help for acute rhinosinusitis and 70% for chronic, were accompanied by the appointment of an antibacterial drug, most often a representative of the penicillin group, which corresponds to modern recommendations. However, unlike those planned, based on the clinical effectiveness of this pathology, macrolides and lincosamides, the other most frequently prescribed drugs were cephalosporins, sulfonamides, trimethoprim and tetracyclines. Intranasal or inhaled glucocorticoids were prescribed in 15 to 16% of cases, for both acute and chronic infections. According to the researchers, the frequency of use of these drugs exceeded that necessary for acute rhinosinusitis and was insufficient for the chronic. The only drugs whose frequency of use was, according to the authors of the justified studies, were antihistamines (25% in acute rhinosinusitis and 21% in chronic).

In general, researchers note that antibiotics and inhaled glucocorticoids are used in the treatment of rhinosinusitis more widely than their effectiveness in this pathology deserves.