Department of Otolaryngology-Head and Neck Surgery, Prince of Wales Hospital, Sydney, Australia.
Department of Otolaryngology-Head and Neck Research Group, Prince of Wales Hospital, Sydney, Australia.
J Laryngol Otol. 2021 Mar;135(3):196-205. doi: 10.1017/S0022215121000542. Epub 2021 Mar 5.
Chronic rhinosinusitis patients with biofilms cultured from their sinonasal cavity have greater symptom burden and risk of recalcitrant disease. A number of non-antibiotic, 'anti-biofilm' treatments exist which show anti-biofilm properties in preclinical studies. There is little evidence evaluating their impact on clinical symptom scores in chronic rhinosinusitis.
A systematic review was performed to assess the literature regarding the efficacy of non-steroid, non-antibiotic, anti-biofilm specific topical therapies in the treatment of chronic rhinosinusitis. The primary outcome assessed was change in validated patient reported outcome measures before and after anti-biofilm treatment.
Thirteen studies assessing the effect of anti-biofilm therapies in chronic rhinosinusitis through validated patient-reported outcome measures were included. Seven different anti-biofilm specific therapies for chronic rhinosinusitis were identified. None of the seven anti-biofilm therapies was identified as being confidently efficacious beyond placebo. Only one therapy (intranasal xylitol) showed a statistically significant reduction in symptom scores compared with placebo in more than one trial.
Robust evidence supporting the use of various anti-biofilm therapies in chronic rhinosinusitis is lacking. Further high quality, human, in vivo trials studying the effect of anti-biofilm therapies in chronic rhinosinusitis are needed to address the deficiencies of the current evidence base.
从鼻腔鼻窦培养出生物膜的慢性鼻-鼻窦炎患者具有更大的症状负担和难治性疾病风险。有许多非抗生素的“抗生物膜”治疗方法在临床前研究中表现出抗生物膜特性。然而，评估它们对慢性鼻-鼻窦炎临床症状评分影响的证据很少。
进行了系统评价，以评估关于非甾体、非抗生素、抗生物膜特异性局部治疗在慢性鼻-鼻窦炎治疗中的疗效的文献。评估的主要结果是抗生物膜治疗前后经过验证的患者报告结果测量的变化。
纳入了 13 项通过经过验证的患者报告结果测量评估抗生物膜疗法对慢性鼻-鼻窦炎影响的研究。确定了七种不同的抗生物膜特异性慢性鼻-鼻窦炎治疗方法。七种抗生物膜疗法中没有一种被确定为明显优于安慰剂。只有一种疗法（鼻内木糖醇）在超过一项试验中显示出与安慰剂相比症状评分有统计学意义的降低。
缺乏支持各种抗生物膜疗法在慢性鼻-鼻窦炎中应用的有力证据。需要进一步开展高质量、人体、体内试验，以研究抗生物膜疗法对慢性鼻-鼻窦炎的影响，从而弥补当前证据基础的不足。
