Royal National Throat Nose and Ear Hospital, London, United Kingdom.
Rhinology. 2010 Sep;48(3):344-7. doi: 10.4193/Rhino09.130.
Acute rhinosinusitis (ARS) is one of the most common presenting conditions to Primary Care physicians. Over-prescription of antibiotics has led to wide debate and divided expert opinion regarding the resulting increasing bacterial resistance or the merits of prevention of more serious complications of ARS. A national prospective audit was undertaken in the UK to evaluate use of antibiotics for ARS in Primary Care.
British Rhinological Society members were asked to contribute patients admitted with complications of ARS, between Feb 2008–Feb 2009 to a national prospective audit via an on-line survey.
Seventy-eight patients were admitted with complications of ARS. The majority of patients were started on antibiotics (59%) prior to admission, with penicillin/amoxicillin being most frequently (64%) prescribed. Similar complication rates were seen in patients treated with and without prior antibiotics.
Despite prior antibiotic treatment, complications of ARS seem to occur sporadically. Our study has shown that the complications which require surgical treatment are similar in both the prior antibiotic treated group and the no prior antibiotic group, suggesting limited benefit of oral antibiotics in the Primary Care setting. Early recognition with CT scanning and appropriate hospital management is essential to reduce any subsequent morbidity or mortality.
急性鼻-鼻窦炎（ARS）是初级保健医生最常见的就诊病症之一。抗生素的过度处方导致了广泛的争论，并在抗生素耐药性不断增加的后果以及预防 ARS 更严重并发症的益处方面存在意见分歧。在英国进行了一项全国性前瞻性审计，以评估初级保健中抗生素治疗 ARS 的情况。
英国鼻科学会成员被要求通过在线调查，为 2008 年 2 月至 2009 年 2 月期间因 ARS 并发症入院的患者提供全国性前瞻性审计。
78 名患者因 ARS 并发症入院。大多数患者在入院前已开始使用抗生素（59%），其中最常开的是青霉素/阿莫西林（64%）。在使用和不使用抗生素之前治疗的患者中，并发症的发生率相似。
尽管之前使用了抗生素治疗，但 ARS 的并发症似乎还是会偶尔发生。我们的研究表明，需要手术治疗的并发症在使用抗生素和未使用抗生素的患者中相似，这表明口服抗生素在初级保健环境中获益有限。早期通过 CT 扫描识别并进行适当的医院管理对于减少任何后续的发病率或死亡率至关重要。
