Burkhardt F, Thumfart W, Waller G
Laryngol Rhinol Otol (Stuttg). 1979 Apr;58(4):347-52.
Surgical treatment of chronic sinusitis is usually preceeded by the attempt of curing the disease by antibiotic and antiphlogistic therapy. Since no studies on the concentration of antibiotics in chronic-hyperplastic mucosa of the maxillary sinuses could be found in the literature, two groups of each 20 patients were subjected to treatment with ampicilline (Binotal) and doxycycline (Vibramycin) respectively and the concentrations of the antibiotics in the maxillary sinus tissue gained during operation were measured. It was shown that therapy with doxycycline produces higher tissue levels than with ampicilline. So it can be assumed that with doxycycline the treatment of chronic-hyperplastic sinusitis will be more frequently successful than with ampicilline. But, with regard to the tissue concentrations found in the study, also with doxycycline only part of infections (e. g. due to certain grampositive cocci, hemophilic bacteria, Pasteurellae) seems to be controllable. Since bacteria of different species could be isolated from the excided mucosa of about 50% of the patients and, on the other hand, the serum levels especially in case of doxycycline were constantly high, the prophylactic use of this drug before operation is recommended in order to avoid inflammatory complications.
慢性鼻窦炎的外科治疗通常在尝试通过抗生素和抗炎治疗治愈疾病之后进行。由于在文献中未发现关于上颌窦慢性增生性黏膜中抗生素浓度的研究，因此分别对两组各20例患者使用氨苄西林（必欣妥）和多西环素（强力霉素）进行治疗，并测量手术中获取的上颌窦组织中抗生素的浓度。结果表明，多西环素治疗产生的组织水平高于氨苄西林。因此可以假设，使用多西环素治疗慢性增生性鼻窦炎比使用氨苄西林更有可能成功。但是，就研究中发现的组织浓度而言，即使使用多西环素，似乎也只能控制部分感染（例如由某些革兰氏阳性球菌、嗜血杆菌、巴斯德氏菌引起的感染）。由于约50%的患者切除的黏膜中可分离出不同种类的细菌，另一方面，尤其是多西环素治疗时血清水平持续较高，因此建议在手术前预防性使用该药以避免炎症并发症。
