Endoscopic sinus surgery reduces antibiotic utilization in rhinosinusitis

Naveen D. Bhandarkar, Jess C. Mace, Timothy Smith

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: Antibiotics are a mainstay of treatment for chronic rhinosinusitis (CRS) and recurrent acute rhinosinusitis (RARS). Although quality-of-life outcomes following endoscopic sinus surgery (ESS) have been studied, the change in antibiotic utilization following ESS is less well known. Objective: We aimed to determine the effect of ESS on antibiotic utilization in CRS and RARS. Methods: A multi-institutional, prospective cohort of patients with CRS and RARS was enrolled between January 2001 and January 2009. Patients completed the medication subscale of the Chronic Sinusitis Survey (CSS), and the Wilcoxon signed-rank test was used to compare differences in the overall reported time of antibiotic between preoperative and postoperative time points. Results: A total of 503 patients were followed for an average 17.3 months. Overall, patients reported a 57.2% reduction in time on antibiotics following ESS. The majority of patients (60.4%) reported significantly less antibiotic utilization after ESS (p <0.001) consisting of an 83.7% reduction in the time on antibiotics. Subgroup analysis also revealed a significant reduction in antibiotic utilization for patients with and without nasal polyposis (59.0% and 58.2%; both p <0.001) as well as RARS (61.2%; p = 0.001). Conclusion: ESS significantly reduces antibiotic utilization for CRS and RARS. This finding demonstrates potential for lower health care expenditures related to antibiotics, as well as reduced risk of both antibiotic related morbidity and development of bacterial resistance.

Original languageEnglish (US)
Pages (from-to)18-22
Number of pages5
JournalInternational Forum of Allergy and Rhinology
Volume1
Issue number1
DOIs
StatePublished - Jan 2011

Fingerprint

Anti-Bacterial Agents
Sinusitis
Nonparametric Statistics
Health Expenditures
Nose
Quality of Life
Morbidity
Delivery of Health Care

Keywords

  • Antibiotics
  • Chronic rhinosinusitis
  • Endoscopic
  • Outcomes
  • Quality-of-life
  • Recurrent acute
  • Sinus, reduction
  • Sinusitis
  • Surgery

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology
  • Medicine(all)

Cite this

Endoscopic sinus surgery reduces antibiotic utilization in rhinosinusitis. / Bhandarkar, Naveen D.; Mace, Jess C.; Smith, Timothy.

In: International Forum of Allergy and Rhinology, Vol. 1, No. 1, 01.2011, p. 18-22.

Research output: Contribution to journalArticle

@article{52418f5eedce44cb8d8ec59a9aae5416,
title = "Endoscopic sinus surgery reduces antibiotic utilization in rhinosinusitis",
abstract = "Background: Antibiotics are a mainstay of treatment for chronic rhinosinusitis (CRS) and recurrent acute rhinosinusitis (RARS). Although quality-of-life outcomes following endoscopic sinus surgery (ESS) have been studied, the change in antibiotic utilization following ESS is less well known. Objective: We aimed to determine the effect of ESS on antibiotic utilization in CRS and RARS. Methods: A multi-institutional, prospective cohort of patients with CRS and RARS was enrolled between January 2001 and January 2009. Patients completed the medication subscale of the Chronic Sinusitis Survey (CSS), and the Wilcoxon signed-rank test was used to compare differences in the overall reported time of antibiotic between preoperative and postoperative time points. Results: A total of 503 patients were followed for an average 17.3 months. Overall, patients reported a 57.2{\%} reduction in time on antibiotics following ESS. The majority of patients (60.4{\%}) reported significantly less antibiotic utilization after ESS (p <0.001) consisting of an 83.7{\%} reduction in the time on antibiotics. Subgroup analysis also revealed a significant reduction in antibiotic utilization for patients with and without nasal polyposis (59.0{\%} and 58.2{\%}; both p <0.001) as well as RARS (61.2{\%}; p = 0.001). Conclusion: ESS significantly reduces antibiotic utilization for CRS and RARS. This finding demonstrates potential for lower health care expenditures related to antibiotics, as well as reduced risk of both antibiotic related morbidity and development of bacterial resistance.",
keywords = "Antibiotics, Chronic rhinosinusitis, Endoscopic, Outcomes, Quality-of-life, Recurrent acute, Sinus, reduction, Sinusitis, Surgery",
author = "Bhandarkar, {Naveen D.} and Mace, {Jess C.} and Timothy Smith",
year = "2011",
month = "1",
doi = "10.1002/alr.20005",
language = "English (US)",
volume = "1",
pages = "18--22",
journal = "International Forum of Allergy and Rhinology",
issn = "2042-6976",
publisher = "Wiley-Blackwell",
number = "1",

}

TY - JOUR

T1 - Endoscopic sinus surgery reduces antibiotic utilization in rhinosinusitis

AU - Bhandarkar, Naveen D.

AU - Mace, Jess C.

AU - Smith, Timothy

PY - 2011/1

Y1 - 2011/1

N2 - Background: Antibiotics are a mainstay of treatment for chronic rhinosinusitis (CRS) and recurrent acute rhinosinusitis (RARS). Although quality-of-life outcomes following endoscopic sinus surgery (ESS) have been studied, the change in antibiotic utilization following ESS is less well known. Objective: We aimed to determine the effect of ESS on antibiotic utilization in CRS and RARS. Methods: A multi-institutional, prospective cohort of patients with CRS and RARS was enrolled between January 2001 and January 2009. Patients completed the medication subscale of the Chronic Sinusitis Survey (CSS), and the Wilcoxon signed-rank test was used to compare differences in the overall reported time of antibiotic between preoperative and postoperative time points. Results: A total of 503 patients were followed for an average 17.3 months. Overall, patients reported a 57.2% reduction in time on antibiotics following ESS. The majority of patients (60.4%) reported significantly less antibiotic utilization after ESS (p <0.001) consisting of an 83.7% reduction in the time on antibiotics. Subgroup analysis also revealed a significant reduction in antibiotic utilization for patients with and without nasal polyposis (59.0% and 58.2%; both p <0.001) as well as RARS (61.2%; p = 0.001). Conclusion: ESS significantly reduces antibiotic utilization for CRS and RARS. This finding demonstrates potential for lower health care expenditures related to antibiotics, as well as reduced risk of both antibiotic related morbidity and development of bacterial resistance.

AB - Background: Antibiotics are a mainstay of treatment for chronic rhinosinusitis (CRS) and recurrent acute rhinosinusitis (RARS). Although quality-of-life outcomes following endoscopic sinus surgery (ESS) have been studied, the change in antibiotic utilization following ESS is less well known. Objective: We aimed to determine the effect of ESS on antibiotic utilization in CRS and RARS. Methods: A multi-institutional, prospective cohort of patients with CRS and RARS was enrolled between January 2001 and January 2009. Patients completed the medication subscale of the Chronic Sinusitis Survey (CSS), and the Wilcoxon signed-rank test was used to compare differences in the overall reported time of antibiotic between preoperative and postoperative time points. Results: A total of 503 patients were followed for an average 17.3 months. Overall, patients reported a 57.2% reduction in time on antibiotics following ESS. The majority of patients (60.4%) reported significantly less antibiotic utilization after ESS (p <0.001) consisting of an 83.7% reduction in the time on antibiotics. Subgroup analysis also revealed a significant reduction in antibiotic utilization for patients with and without nasal polyposis (59.0% and 58.2%; both p <0.001) as well as RARS (61.2%; p = 0.001). Conclusion: ESS significantly reduces antibiotic utilization for CRS and RARS. This finding demonstrates potential for lower health care expenditures related to antibiotics, as well as reduced risk of both antibiotic related morbidity and development of bacterial resistance.

KW - Antibiotics

KW - Chronic rhinosinusitis

KW - Endoscopic

KW - Outcomes

KW - Quality-of-life

KW - Recurrent acute

KW - Sinus, reduction

KW - Sinusitis

KW - Surgery

UR - http://www.scopus.com/inward/record.url?scp=84861144955&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84861144955&partnerID=8YFLogxK

U2 - 10.1002/alr.20005

DO - 10.1002/alr.20005

M3 - Article

VL - 1

SP - 18

EP - 22

JO - International Forum of Allergy and Rhinology

JF - International Forum of Allergy and Rhinology

SN - 2042-6976

IS - 1

ER -