Endoscopic sinus surgery for chronic rhinosinusitis independently leads to less antibiotics and oral corticosteroids usage

Background Antibiotics and oral corticosteroids usage for chronic rhinosinusitis (CRS) is reflective of poor disease control. We sought to determine how endoscopic sinus surgery (ESS) would impact the usage of these systemic medications for CRS.

Materials and methods Prospective longitudinal study of 78 CRS patients undergoing comprehensive ESS for medically recalcitrant CRS. CRS burden was measured using SNOT-22 score, CRS-related antibiotics usage and CRS-related oral corticosteroids usage in past 3 months reported at time of ESS and 1 year after ESS.

Results After ESS, SNOT-22 score decreased by mean 22.8 points, CRS-related antibiotics usage in the past 3 months decreased by mean 1.1 courses and CRS-related oral corticosteroids usage in the past 3 months decreased by mean 0.5 courses. In patients with usage of these systemic medications pre-operatively, antibiotics usage decreased by mean 1.7 courses and oral corticosteroids usage decreased by mean 1.0 course. Change in antibiotics usage was associated with pre-operative antibiotics usage (b=-1.1, 95 %CI: -0.9 to -1.2, p < 0.001), oral corticosteroids usage (b = 0.3, 95 %CI: 0.1–0.5, p = 0.041) and smoking (b = 2.0, 95 %CI: 0.9–3.1, p < 0.001). Change in oral corticosteroids usage was associated with pre-operative oral corticosteroids usage (b= -0.7, 95 %CI: -0.9 to -0.6, p < 0.001) and antibiotics usage (b= -0.1, 95 %CI: -0.2–0.0, p = 0.044). Pre-operative SNOT-22 was not associated with change in systemic medication usage.

Discussion ESS reduces systemic antibiotics and corticosteroids usage for CRS, independent of CRS symptomatology. CRS-related antibiotics and oral corticosteroids usage are independent measures of CRS disease control that should be assessed as ESS outcomes.

Poster-PDF A-1071.PDF

Publication History

Article published online:
10 June 2020