Department of Pediatrics and Medicine, Georgetown University School of Medicine, Washington, DC 20016, USA.
Expert Opin Pharmacother. 2010 Apr;11(5):755-69. doi: 10.1517/14656561003598901.
Rhinosinusitis is a common illness that represents a substantial economic burden. The vast majority of cases resolve spontaneously but a small proportion develops a secondary bacterial infection. Accurate diagnosis of rhinosinusitis depends upon clinical assessment. Isolation of the causative agents must be considered in cases failing initial treatment.
This up-to-date review defines the anatomy, pathogenesis, phases of rhinosinusitis, the unique microbiology of each type of rhinosnusitis (acute and chronic, acute exacerbation, nosocomial, rhinosinusitis in immunocompromised host, and rhinosinusitis of ododental origin), clinical features, diagnosis, and treatment.
The reader will gain understanding of the above issues and logic for choosing the appropriate treatment for each condition of rhinosinusitis.
The proper choice of antibiotic therapy depends on the probable infecting pathogens, bacterial antibiotic resistance and antibiotics' pharmacologic profiles. In addition to antibiotics, adjuvant therapies and surgery are used in the management of bacterial sinusitis. Accurate diagnosis and careful consideration when choosing therapy for rhinosinusitis will optimize the chances of achieving an early recovery and avoiding complications.
鼻窦炎是一种常见的疾病，代表着巨大的经济负担。绝大多数病例会自行缓解，但一小部分会发展成继发性细菌感染。鼻窦炎的准确诊断依赖于临床评估。在初始治疗失败的情况下，必须考虑分离致病因子。
本篇最新综述定义了解剖学、发病机制、鼻窦炎的各个阶段、每种类型鼻窦炎（急性和慢性、急性加重、院内、免疫功能低下宿主的鼻窦炎和源于口咽的鼻窦炎）的独特微生物学、临床特征、诊断和治疗。
读者将了解上述问题和为每种鼻窦炎选择适当治疗的逻辑。
抗生素治疗的正确选择取决于可能的感染病原体、细菌抗生素耐药性和抗生素的药物特征。除了抗生素，辅助治疗和手术也用于细菌性鼻窦炎的治疗。准确的诊断和仔细考虑治疗鼻窦炎的方法可以优化早期康复和避免并发症的机会。
