THE INCREASE OF TREATMENT EFFICIENCY OF BACTERIAL RINOSINUSITIS
About the author:
Bezshapochny S. B., Ivanchenko S. A., Gryshyna I. S.
CLINICAL AND EXPERIMENTAL MEDICINE
Type of article:
The article describes a problem of treatment of bacterial rhinosinusitis. WHO claims that the prevalence of the disease is increasing every year. In Ukraine, the diagnosis of “rhinosinusitis” is exposed to 60-65% of patients who seek help from an otorhinolaryngologist. It is proved, that during an inflammatory process, the intake of a drug from the bloodstream into the mucous membrane of the nose and paranasal sinuses is sharply reduced, due to an increase of the interstitial pressure, there is compression of the capillaries, which leads to a deterioration of blood flow and filtration. Due to this fact it was concluded that the optimal therapeutic effect of the drug is achieved when it is applied directly into the inflammated area. In this regard, our attention was drawn to the unique combination in the form of a nasal spray containing two differently directed antibiotics: neomycin sulfate and polymyxin B sulfate, dexamethasone sodium – a corticosteroid for reducing the inflammation, and phenylephrine hydrochloride – a decongestant to relieve nasal congestion and improving the outflow of secretions from the natural anastomoses of the paranasal sinuses. The aim of the research was to study the effectiveness of using the combination of neomycin sulfate + polymyxin B sulfate + dexamethasone sodium + phenylephrine hydrochloride in comparison with mometasone furoate and saline solutions in the complex therapy of bacterial rhinosinusitis. The study was conducted on the base of the department of otorhinolaryngology with ophthalmology HSEEU “Ukrainian Medical Stomatological Academy”, ENT department of the Poltava Regional Clinical Hospital, the 4th city clinical polyclinic in Poltava. All patients were divided into 3 groups. The first group included 30 people who received oral antibiotic therapy with amoxicillin trihydrate with a dose of 500 mg x 2 times per day for 10 days, the combination of neomycin sulfate 6500 IU + polymyxin B sulfate 10000 IU + dexamethasone sodium 0,25 mg + phenylephrine hydrochloride 2,5 mg locally for 1 injection in each nasal passage x 3 times per day for 5 days. Patients of the other group (n = 30) received amoxicillin trihydrate 500 mg x 2 times per day for 10 days, a nasal spray of mometasone furoate 50 μg for 2 injections in each nasal passage x 2 times per day for 5 days. Patients of the control group were prescribed amoxicillin trihydrate 500 mg x 2 times per day for 10 days, an intranasal spray based on sea water x 3 times per day for 5 days. It was found that the combination of neomycin sulfate + polymyxin B sulfate + dexamethasone sodium + phenylephrine hydrochloride in form of spray has not only the same level by its effectiveness to the momentozone furoate, but exceeds it by such indicators as edema of the nasal concha and hyperemia – by 0.2 points, rheum from the middle nasal passage – by 0,6 points, nasal congestion – by 0.14 points. There was a difference between the group which received the combination of neomycin sulfate + polymyxin B sulfate + dexamethasone sodium + phenylephrine hydrochloride in form of spray and the group of the intranasal saline solution in favor of the first: the degree of the edema of the nasal concha decreased by 1.8 points, the hyperemia of the nasal concha was decreased by 2 points, the discharge from the middle nasal passage – on 2.1 points, nasal congestion – by 1.6 points, loss of smell – by 1.1 points. As a result of the research, we came to the conclusion that due to the complex effects of antibacterial and steroidal anti-inflammatory components, combination of neomycin sulfate + polymyxin B sulfate + dexamethasone sodium + phenylephrine hydrochloride in form of spray is the drug of choice in the complex treatment of bacterial rhinosinusitis.
rhinosinusitis, neomycin sulfate, polymyxin B sulfate, dexamethasone sodium, phenylephrine hydrochloride, mometasone furoate
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Publication of the article:
«Bulletin of problems biology and medicine» Issue 2 (144), 2018 year, 138-141 pages, index UDK 616. 211 – 002.2 – 056