Clinical Course of Acute and Chronic Rhinosinusitis and Modern Treatment Methods: the Role of Antibiotic Therapy
DOI:
https://doi.org/10.51699/cajitmf.v7i2.1260Keywords:
Acute Rhinosinusitis, Chronic Rhinosinusitis, Antibiotics, Antibiotic Resistance, SNOT-22, VAS, Endoscopy, CT, Inflammation, Polypoid Rhinosinusitis, TherapyAbstract
Acute and chronic rhinosinusitis remain among the most common conditions in clinical practice, significantly affecting patients’ quality of life and healthcare costs. Despite the predominantly viral nature of acute rhinosinusitis, antibiotics continue to be widely prescribed, contributing to the rise of antibiotic resistance and disruption of the microbiota. The aim of this study was to evaluate the clinical manifestations of acute and chronic rhinosinusitis and to assess the effectiveness and appropriateness of antibiotic therapy. A retrospective cohort study was conducted including 120 patients (2022–2024), of whom 70 had acute rhinosinusitis and 50 had chronic rhinosinusitis (including forms with and without nasal polyps). Patient assessment included clinical examination, nasal endoscopy, CT imaging, the Visual Analogue Scale (VAS), and the SNOT-22 quality-of-life questionnaire. The results showed that in most cases, acute rhinosinusitis was of viral origin, and antibiotic therapy did not significantly affect disease duration or symptom severity (p > 0.05). Symptomatic treatment demonstrated comparable effectiveness and safety. Patients with chronic rhinosinusitis exhibited a significant reduction in quality of life; however, comprehensive therapy led to a statistically significant improvement in SNOT-22 scores (p < 0.05). The use of antibiotics in chronic cases showed limited effectiveness and was mainly justified during exacerbations. The use of phage therapy demonstrated comparable clinical outcomes, warranting further investigation. In conclusion, the findings highlight the importance of rational antibiotic use in rhinosinusitis management. In acute cases, symptomatic treatment should be preferred, whereas chronic rhinosinusitis requires a comprehensive anti-inflammatory approach aimed at improving quality of life and achieving disease control.
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