Evidence map›Paper›PMID 30582166›Full record

Observational studyThe Laryngoscope2019

Is greater antibiotic therapy prior to ESS associated with differences in surgical outcomes in CRS?

Vijay R Ramakrishnan, Jess C Mace, Zachary M Soler, Timothy L Smith

Abstract readMulticenter StudyObservational Study
In one paragraph

Observational study in The Laryngoscope, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Vijay R RamakrishnanDepartment of Otolaryngology, University of Colorado, Aurora, Colorado.ORCID 0000-0003-2748-0705
Jess C MaceDepartment of Otolaryngology-Head and Neck Surgery, Oregon Health Sciences University, Portland, Oregon.
Zachary M SolerDepartment of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
Timothy L SmithDepartment of Otolaryngology-Head and Neck Surgery, Oregon Health Sciences University, Portland, Oregon.

Funding

DETERMINANTS OF SURGICAL OUTCOMES IN CHRONIC SINUSITISR01DC005805 · NIDCD · OREGON HEALTH & SCIENCE UNIVERSITY · PI SMITH, TIMOTHY L, SOLER, ZACHARY M · 2004 to 2020
$7.6M
Role of taste signaling in airway epithelial functionK23DC014747 · NIDCD · UNIVERSITY OF COLORADO DENVER · PI RAMAKRISHNAN, VIJAY · 2015 to 2020
$1.2M
Olfactory-specific inflammation and disease severity in chronic rhinosinusitisR03DC013651 · NIDCD · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI SOLER, ZACHARY M · 2013 to 2015
$449k
NIDCD NIH HHS K23 DC014747NIDCD NIH HHS R01 DC005805NIDCD NIH HHS R03 DC013651
6 · The paper itself

Abstract

objectiveAntibiotics have been a mainstay of chronic rhinosinusitis therapy; however, data suggest that antibiotics may also result in several adverse unintended consequences. We aimed to evaluate if greater antibiotic use prior to sinus surgery was associated with differences in surgical outcomes.

methodsAdult CRS patients enrolled in a prospective, multi-institutional, observational cohort study were asked to recall systemic antibiotic use in the 90 days prior to endoscopic sinus surgery (ESS). Antibiotic use was examined in relation to demographics, disease characteristics, and outcomes.

resultsData were collected for 271 study participants followed for a mean of 14.9 [± 5.1] months across four institutions, with a mean preoperative antibiotic use of 27.8 [± 22.7] days out of the 90 preceding ESS. After ESS, significant improvement (P < 0.001) was reported for patient-reported outcome measures and endoscopy scores for the overall cohort. No bivariate correlation between preoperative antibiotic use and degree of benefit in objective clinical measures (endoscopy, Brief Smell Identification Test) was seen. Increased preoperative antibiotic use was associated with less improvement in 22-item SinoNasal Outcome Test (SNOT-22) and its rhinologic subdomain after ESS. Prevalence of achieving a minimal clinically important difference in overall SNOT-22 symptom scores was lower in those using more preoperative antibiotics, although statistical significance was not reached when adjusting for independent covariates in multivariate modeling.

conclusionHigher amounts of previous antibiotic use do not appear to be associated with better ESS outcomes. Specific recommendations for antibiotic use as part of CRS-appropriate medical therapy prior to ESS require further study, particularly given concerns for antibiotic overuse and implications for improving outcomes in the modern healthcare era. LEVEL OF EVIDENCE: 2C Laryngoscope, 129:558-566, 2019.

Indexed as

EndoscopyAnti-Bacterial AgentsChronic DiseaseCohort StudiesFemaleHumansMaleMiddle AgedParanasal SinusesPreoperative PeriodProspective StudiesRhinitisSinusitisTreatment OutcomeAnti-Bacterial Agentsantibacterialendoscopymulticenter studyoutcome assessment (healthcare)prospective studiesSinusitissinus surgery

Identifiers

PMID30582166
PMCPMC6402589

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.