BACKGROUND: Topical antibiotics, delivered optimally as high-volume culture-directed sinus irrigations, are being increasingly used for recalcitrant @entity102 ( @entity102 ). Their impact on subjective and objective outcome measures, however, is still unclear. OBJECTIVE: To assess if the use of topical antibiotics in recalcitrant @entity102 is associated with improved 20-Item Sino-Nasal Outcome Test and Lund-Kennedy endoscopic scores, and to determine the negative posttreatment culture "control" rate. METHODS: @entity1 were included in the study if they met diagnostic criteria for @entity102 , received high-volume topical antibiotic sinus irrigations twice daily for 1 month, between December 2009 and May 2015, and had undergone endoscopic sinus surgery. The primary outcome was the 20-Item Sino-Nasal Outcome Test score. Secondary outcomes were the Lund-Kennedy endoscopic score and a negative posttreatment culture "control" rate. Paired t-tests were used to compare pre- and posttreatment scores. @entity1 with @entity1577 were analyzed separately. RESULTS: Of the 58 @entity1 included, 47% had @entity1412 , 57% had @entity565 , 16% had @entity117 sensitivity, and 55% had @entity566 . The median Lund-Mackay computed tomography score was 11 (interquartile range, 6-16), and the median time to follow-up was 8 weeks (interquartile range, 6-10 weeks). The 20-Item Sino-Nasal Outcome Test scores improved from pre- to posttreatment period, although this was not significant mean 1.5 [confidence interval {CI} 1.3, 1.7] to mean 1.3 [CI 1.1, 1.6]; p = 0.16). Lund-Kennedy endoscopic scores, however, significantly improved from pre- to posttreatment (mean 4.9 [CI 4.3, 5.6] to mean 4.1 [CI 3.5, 4.7]; p = 0.05). Of the 47 @entity1 with complete culture data, 72% had negative posttreatment culture results, defined as "controlled." Only one @entity1 discontinued treatment, related to discomfort from irrigations. CONCLUSION: In @entity1 with recalcitrant @entity102 , the use of topical antibiotics trended toward improvement in symptom severity and significantly improved endoscopic appearance. Furthermore, 72% had negative posttreatment culture results, meaning microbiological "control." The results of this study support the use of high-volume culture-directed topical antibiotics, and, in the future, more rigorous prospective studies are warranted.

Culture-directed topical antibiotic treatment for XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity565 :: ('MESH:D001249', 'Disease') :: ['asthma'] @entity117 :: ('MESH:D001241', 'Chemical') :: ['aspirin'] @entity566 :: ('MESH:D006967', 'Disease') :: ['environmental allergies'] @entity102 :: ('MESH:D002908', 'Disease') :: ['chronic rhinosinusitis', 'CRS'] @entity1412 :: ('MESH:D011125', 'Disease') :: ['nasal polyposis'] @entity1577 :: ('MESH:D003550', 'Disease') :: ['cystic fibrosis']
@entity102 :: (MESH:D002908,Disease) :: ['chronic rhinosinusitis']
