Observational studyInternational forum of allergy & rhinology2017
Examination of high-antibiotic users in a multi-institutional cohort of chronic rhinosinusitis patients.
Observational study in International forum of allergy & rhinology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Definition and characteristics of acute exacerbation in adult patients with chronic rhinosinusitis: a systematic review.Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale · 2020Pooled it
- Age-Associated Changes of Nasal Bacterial Microbiome in Patients With Chronic Rhinosinusitis.Frontiers in cellular and infection microbiology · 2022Article
- Healthcare Resource Utilization for Chronic Rhinosinusitis in Older Adults.Healthcare (Basel, Switzerland) · 2021Article
- Ethmoid-to-maxillary opacification ratio: a predictor of postoperative olfaction and outcomes in nasal polyposis?International forum of allergy & rhinology · 2021Observational
- Predicting olfactory loss in chronic rhinosinusitis using machine learning.Chemical senses · 2021Observational
- Clinical factors associated with acute exacerbations of chronic rhinosinusitis.The Journal of allergy and clinical immunology · 2020Article
- Is greater antibiotic therapy prior to ESS associated with differences in surgical outcomes in CRS?The Laryngoscope · 2019Observational
- Impact of antibiotics on smell dysfunction.World journal of otorhinolaryngology - head and neck surgery · 2018Article
- What drives productivity loss in chronic rhinosinusitis? A SNOT-22 subdomain analysis.The Laryngoscope · 2018Observational
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundIn addition to known concerns regarding antibiotic overuse, recent research indicates that excessive antibiotic use is associated with poorer long-term health. Given that rhinosinusitis is the leading condition accounting for antibiotic prescriptions in the ambulatory setting, we aimed to evaluate characteristics associated with greater antibiotic use in chronic rhinosinusitis (CRS).
methodsAdult CRS patients enrolled in a prospective, multi-institutional, observational cohort study evaluating treatment outcomes were included in this analysis. Study participants were asked to report the number of days out of the previous 90 days that systemic antibiotics were taken for sinus disease. Patient demographics, disease characteristics, and measures of disease severity were evaluated.
resultsA total of 561 patients from 4 institutions were included in the analysis, with mean antibiotic use of 17.4 ± 22.4 out of the prior 90 days. No differences between antibiotic-use groups were found for objective measures of disease severity (computed tomography [CT], endoscopy, Brief Smell Identification Test [BSIT] scores), however, increased patient-reported symptom burden (22-item Sino-Nasal Outcome Test [SNOT-22], Rhinosinusitis Disability Index [RSDI]) was associated with more antibiotic use. Patients reporting the most antibiotic use were older (p = 0.004) but no ethnic or gender differences were seen. Comorbid diagnoses of allergy, asthma, diabetes, depression, or fibromyalgia were not associated with increased antibiotic use. In accordance with literature recommendations, CRS with nasal polyps (CRSwNP) patients were less likely to have used antibiotics. Endoscopic sinus surgery (ESS) significantly decreased antibiotic use.
conclusionVariability in antibiotic use in CRS appears to be driven by symptom burden, independent of objective measures of disease severity, patient demographics, and presence of comorbid disease. Clear guidelines are essential to define appropriate antibiotic use in CRS.
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