Antibiotic Use In Patients With Chronic Rhinosinusitis, With and Without Bronchiectasis, After Functional Endoscopic Sinus Surgery
Sunday, March 4, 2018
South Hall A2 (Convention Center)
Raul S. Villarreal, MD, Whitney W. Stevens, MD PhD, Robert P. Schleimer, PhD FAAAAI, Bruce K. Tan, MD, MS, Robert C. Kern, MD, Leslie C. Grammer, MD FAAAAI, David B. Conley, MD, Kevin C. Welch, MD, Stephanie S. Smith, MD, Anju T. Peters, MD FAAAAI


Non-cystic fibrosis bronchiectasis is associated with chronic rhinosinusitis (CRS). The impact bronchiectasis has on CRS patient outcomes remains unclear. This study evaluates antibiotic courses for sinopulmonary infections during a 4-year period, 2 years pre and post functional endoscopic sinus surgery (FESS), in CRS patients with and without bronchiectasis.


CRSsNP or CRSwNP patients with and without bronchiectasis evaluated at Northwestern Medicine between 2002-2013 were randomly identified in an electronic database. A retrospective chart review of their medical records was performed and the number of antibiotic courses prescribed for sinopulmonary infections, which included sinus and/or respiratory symptoms, 2 years before and 2 years after FESS was determined.


Among CRSsNP patients without bronchiectasis (N=21), there was a significant reduction in number of antibiotics prescribed 2 years post-surgery (2.39+0.85 pre vs 0.72+0.96 post, p<0.001). However, no significant reduction in antibiotic use was observed in CRSsNP patients (N=11) who also had bronchiectasis (3.00+2.10 pre vs 2.80+1.80 post, p=0.73). Similarly, the number of antibiotic courses was reduced after surgery in patients with CRSwNP without bronchiectasis (N=11) from 2.46+1.00 pre to 1.09+1.30 post (p=0.02) compared to 3.18+2.30 pre and 3.55+1.90 post in patients with both CRSwNP and bronchiectasis (N= 11) (p = 0.70).


Although surgery appears to have reduced antibiotic use in CRS patients without bronchiectasis, patients with either CRSsNP or CRSwNP and bronchiectasis had no significant reduction in prescribed antibiotic courses for sinopulmonary infections following sinus surgery. This suggests that FESS may be of less benefit for CRS patients that have the comorbidity of bronchiectasis.