trimethoprim--sulfamethoxazole-drug-combination and Rhinitis

Topics: Adrenal Cortex Hormones; Antibodies, Monoclonal; Asthma; Drug Hypersensitivity; Food Additives; Food Hypersensitivity; Humans; Humidity; Hypersensitivity; Immunoglobulin E; Latex Hypersensitivity; Rhinitis; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Antibodies, Antineutrophil Cytoplasmic; Autoantibodies; Azathioprine; Biopsy; Cyclophosphamide; Glomerulonephritis; Granulomatosis with Polyangiitis; Humans; Lung; Prednisone; Radiography; Rhinitis; Stomatitis; Trimethoprim, Sulfamethoxazole Drug Combination

TREATMENT OF SINUSITIS: For both acute rhinosinusitis in patients with no past history where S. pneumoniae and H. influenzae are the main causal agents, or recurrent sinusitis in a chronic background where anaerobic bacteria are increasingly implicated, pristinamycin is one of the rare compounds which can be expected to be effective and is a treatment of choice for an empirical strategy. LOWER RESPIRATORY TRACT INFECTIONS: Besides high-risk subjects with non-microbiologically proven bronchial infection, where enterobacteriaceae could involve a pristinamycin is a useful alternative to the conventional strategy (i.e.: amoxicillin, macrolides and cotrimoxazole) in the treatment of LRT infection.

Topics: Acute Disease; Adult; Amoxicillin; Bronchial Diseases; Bronchitis; Female; Humans; Macrolides; Male; Respiratory Tract Infections; Rhinitis; Sinusitis; Trimethoprim, Sulfamethoxazole Drug Combination; Virginiamycin

Trimethoprim/sulfamethoxazole has been suggested as a treatment option for chronic rhinosinusitis with purulence. This study aimed to assess the functional and endoscopic outcomes after a three-month course of low-dose trimethoprim/sulfamethoxazole.. A prospective study was performed, comprising patients referred to a tertiary care medical centre with a diagnosis of chronic rhinosinusitis with purulence. Trimethoprim/sulfamethoxazole was prescribed at 960 mg/day for three months. Sinonasal complaints and endoscopic findings were documented, and bacteriological data were compared.. Fifteen patients were included. Staphylococcus aureus was the most common bacterium cultured (86 per cent). Improvement in nasal function, as measured by the 22-item Sino-Nasal Outcome Test, was highly significant at three months (p < 0.0005). This improvement slightly decreased but remained significant at 6, 9 and 12 months. No side effects were noted. Endoscopic scores revealed similar and concordant improvements.. Long-term low-dose trimethoprim/sulfamethoxazole therapy seems to be a safe option for selected patients. Additional randomised multicentre studies remain necessary.

Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Chronic Disease; Endoscopy; Female; Humans; Male; Middle Aged; Nasal Cavity; Nasal Surgical Procedures; Prospective Studies; Rhinitis; Sinusitis; Staphylococcal Infections; Staphylococcus aureus; Time; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination; Young Adult

A 5-year-old female had history of chronic foul smelling nasal discharge. Rhinoscopy showed greenish crusts lining the nasal cavities and inferior turbinates were shriveled significantly. Nasal cavity cultures of crusts by swab revealed Klebsiella ozaenae making the diagnosis of primary atrophic rhinosinusitis. After several unsuccessful treatment, we have decided to try sulfamethoxazole-trimethoprim prophylaxis and 1 year later there was a complete clinical improvement. There are many medical therapies and surgical options described, but none of them showed effective at long term. We present antibiotic prophylaxis as a viable alternative for long term control of the disease.

Topics: Anti-Bacterial Agents; Atrophy; Child, Preschool; Endoscopy; Female; Humans; Klebsiella Infections; Nasal Cavity; Rhinitis; Sinusitis; Trimethoprim, Sulfamethoxazole Drug Combination; Turbinates

Despite their widespread use, antibiotics have not been shown to improve chronic rhinosinusitis (CRS) outcomes. We aimed to determine whether culture-inappropriate postoperative antibiotic therapy was associated with less quality-of-life (QOL) improvement following functional endoscopic sinus surgery (FESS).. This retrospective cohort study recruited 376 adult CRS patients undergoing FESS between October 1, 2007 to December 31, 2011. Patient demographics, comorbidities and medications were collected at baseline. Trimethoprim-sulfamethoxazole and clindamycin were administered for 2 weeks postoperatively. The antibiotic appropriateness was determined based on bacterial resistance profile of organisms identified during intraoperative culture. The QOL outcome was defined as change of 22-item Sinonasal Outcome Test scores from preoperative visit to 1-month, 3-month, and 6-month post-FESS. Clinically significant difference was defined as at least 0.5 standard deviations (SD) of baseline QOL score in the reference group. Mixed-effects regression models were performed.. Seven percent of patients (n = 27) had culture-inappropriate antibiotic therapy, and additional 5% (n = 19) had culture-specific antibiotic adjustment. Compared to patients with culture-appropriate antibiotics, patients with culture-inappropriate antibiotics had significantly less improvement of QOL from baseline to postoperative 1-month and 3-month follow-up where the difference became clinically significant; patients with antibiotic adjustment had more QOL improvement from baseline to 1-month follow-up, but their QOL worsened at 3-month follow-up, and these changes were not clinically significant. However, all effects washed out at 6-month follow-up with no significant differences.. Culture-inappropriate postoperative antibiotic therapy decreased short-term QOL improvement to a clinically meaningful level after FESS. Culture guided selection of antibiotics may improve short-term FESS outcome.

Topics: Adult; Antibiotic Prophylaxis; Chronic Disease; Clindamycin; Cohort Studies; Drug Resistance, Bacterial; Endoscopy; Female; Follow-Up Studies; Humans; Male; Middle Aged; Paranasal Sinuses; Postoperative Period; Quality of Life; Retrospective Studies; Rhinitis; Sinusitis; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

In recalcitrant Chronic RhinoSinusitis (CRS) treatment with intranasal corticosteroids, short-term antibiotics and even sinus surgery is frequently insufficient. Long-term low-dose administration of antibiotics has been suggested as a treatment option in these patients. We analysed the outpatient clinic population treated with different long-term low-dose antibiotics at the AMC Amsterdam.. Eligible patients, who were treated with trimethoprim-sulfamethoxazole or macrolides, were retrospectively identified from our outpatient clinic in 2009. The two main outcome measures were sinonasal complaints and nasal endoscopic findings. A 5-point grading scale was used to score the results compared with the pre-treatment situation. This was measured at several time-points during, and after the antibiotic course, and at the end of the follow-up term.. Seventy-six patients were included, 53 per cent had asthma and all of them had undergone sinus surgery. Seventy-eight per cent showed improvement of the symptoms, and 84 per cent demonstrated improvement of the sinonasal mucosa at the end of the course. No significant difference was found between the trimethoprim-sulfamethoxazole and macrolide group.. Long-term low-dose treatment with antibiotics seems to improve CRS symptoms and the appearance of the sinonasal mucosa on nasal endoscopy. However, at this stage, strong conclusions are immature because no placebo-group has been included. Despite increasing use of long-term low-dose treatment of recalcitrant CRS in referral centres, hard clinical evidence is lacking. More research is urgently required.

Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Child; Chronic Disease; Female; Humans; Macrolides; Male; Middle Aged; Rhinitis; Sinusitis; Trimethoprim, Sulfamethoxazole Drug Combination; Young Adult

We report the case of an HIV-infected woman, who presented with chronic and productive cough without sign of hypersensitivity (fever, cutaneous eruption, gastrointestinal disorders), while taking abacavir. All complementary exams being negative, the involvement of abacavir has been suspected. So the drug was stopped leading to a rapid disappearance of cough. It is the first report of chronic cough with abacavir apart of a context of hypersensitivity reaction.

Topics: Alkynes; Anti-HIV Agents; Antiretroviral Therapy, Highly Active; Benzoxazines; Chronic Disease; Cough; Cyclopropanes; Dideoxynucleosides; Female; HIV Infections; HIV Protease Inhibitors; Humans; Lamivudine; Middle Aged; Nelfinavir; Oxazines; Reverse Transcriptase Inhibitors; Rhinitis; Sputum; Stavudine; Trimethoprim, Sulfamethoxazole Drug Combination

To determine whether treatment with an antibiotic (trimethoprim-sulfamethoxazole) reduced the inflammatory response in a murine form of Streptococcus pneumoniae-induced rhinosinusitis.. We randomized 18 C57BL/6 mice to either treatment with intraperitoneal trimethoprim-sulfamethoxazole (Bactrim, 30 mg/kg) or no treatment (control). After 2 days, we inoculated all C57BL/6 mice intranasally with a Bactrim-susceptible strain of Streptococcus pneumoniae, ATCC 49619, suspended in Trypticase soy broth. At day 5 after bacterial inoculation, we sacrificed the mice and prepared histopathologic sections of their sinuses after culturing their nasal cavities by lavage.. Animal care facility at a tertiary, academic institution.. The histopathologic sections of the sinuses were examined in a blind manner for the percent of sinus cavity area occupied by neutrophil clusters, and for the number of neutrophils per square millimeter of sinus mucosa.. The Bactrim group had a significantly smaller sinus area occupied by neutrophil clusters (1.58% +/- 1.13 vs 4.38% +/- 3.41; P < 0.05), significantly fewer neutrophils infiltrating the mucosa (58.81 +/- 29.63/mm2 vs 105.85 +/- 48.49/mm2; P < 0.05), and significantly less growth of Streptococcus pneumoniae colonies in the intranasal cultures (8 few and 1 moderate vs 3 few, 3 moderate, and 1 many; P = 0.05) compared to the control group.. In our murine model of acute rhinosinusitis, Bactrim decreased the number of neutrophil clusters in the sinus cavities, the number of neutrophils infiltrating the sinus mucosa, and the growth of Streptococcus pneumoniae. We propose that our murine model can be used for the study of the pathophysiology and treatment of acute rhinosinusitis.

Topics: Animals; Disease Models, Animal; Inflammation; Leukocyte Count; Mice; Neutrophils; Rhinitis; Sinusitis; Streptococcal Infections; Streptococcus pneumoniae; Trimethoprim, Sulfamethoxazole Drug Combination

Because of manifestation of Wegener's granulomatosis in the upper respiratory tract the ENT-specialist is often initially involved in diagnosis. Recent research results suppose the chronic nasal carriage of Staphylococcus aureus triggering relapse rate in Wegener's granulomatosis. The adequate therapy of this bacteria as chronic nasal carriage may reduce the number of relapses in patients with Wegener's granulomatosis in remission.. An illustrative case report shows the positive effect of prolonged treatment with cotrimoxazole in a 49-year-old male with a second relapse of Wegener's granulomatosis.. The prolonged treatment of cotrimoxazole reduced the dose of cyclophosphamid and glucocorticoids which show long-term side effects.. 15 years ago a positive effect of cotrimoxazole to Wegener's granulomatosis was discussed. Later immunological and clinical studies confirmed this fact. Prolonged treatment with cotrimoxazole seems to reduce the number of relapses in patients with this chronic disease. Corresponding with our case reduction of the systemic therapy with cyclophosphamid and glucocorticoids is possible.

Topics: Cyclophosphamide; Drug Therapy, Combination; Glucocorticoids; Granulomatosis with Polyangiitis; Humans; Male; Middle Aged; Prednisolone; Recurrence; Rhinitis; Trimethoprim, Sulfamethoxazole Drug Combination

One hundred and fifty-one children aged 2-6 years old suffering from chronic rhinitis were followed and treated for periods of 3-6 months. Seventy-five children were treated with antihistamines (AH) and 76 with antibiotics (AB). Significant statistic difference was found between pre-school children and school children. The differences were both with the nature of the symptoms, and reaction to treatment. While 49% of the school children recovered with AH treatment, only 14% of the pre-school children did. On the other hand, 58% of the pre-school children recovered with AB treatment while only 35% of the older children did. From our results it is clear that in many children bacterial infection is the cause for chronic rhinitis. In pre-school children it is the main cause, while in older children it is the cause in about a third of the cases. It is also important to remember that although allergy might be the basic reason for rhinitis, in certain age groups a secondary bacterial infection might interfere with the efficiency of antiallergic treatment.

Topics: Age Factors; Astemizole; Bacterial Infections; Carbolines; Child; Child, Preschool; Chronic Disease; Follow-Up Studies; Health Status; Histamine H1 Antagonists; Humans; Linear Models; Prognosis; Recurrence; Rhinitis; Rhinitis, Allergic, Perennial; Rhinitis, Allergic, Seasonal; Suppuration; Trimethoprim, Sulfamethoxazole Drug Combination