Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Ill; Center for Health Services and Outcomes Research, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill.
Department of Surgery, The University of Auckland, Auckland, New Zealand.
J Allergy Clin Immunol. 2022 May;149(5):1504-1512. doi: 10.1016/j.jaci.2022.02.004. Epub 2022 Feb 22.
Rhinosinusitis is one of the most common reasons for adult outpatient antibiotic prescriptions, though there is little clinical evidence to support this practice, especially for chronic rhinosinusitis. Despite considerable research, the etiology of chronic rhinosinusitis, including the pathogenic role of microbes, remains poorly understood. Rigorous studies of the efficacy of antibiotic treatment of chronic sinusitis are surprisingly few in number and the results are somewhat conflicting. This review article will review the rationales for and against the treatment of chronic rhinosinusitis with antibiotics, based on current evidence and understanding of pathophysiology, and will also summarize the current guidelines.
鼻窦炎是成年人门诊开抗生素处方的最常见原因之一,但这种做法几乎没有临床证据支持,尤其是对于慢性鼻窦炎。尽管进行了大量研究,但慢性鼻窦炎的病因,包括微生物的致病作用,仍知之甚少。令人惊讶的是,关于抗生素治疗慢性鼻窦炎疗效的严格研究数量很少,结果也有些相互矛盾。基于目前对病理生理学的认识和理解,本文回顾了抗生素治疗慢性鼻窦炎的合理性和反对意见,并对当前的指南进行了总结。