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Table of Contents
Vol. 71, No. 5, 2009
Issue release date: November 2009
Section title: Original Paper
ORL 2009;71:263–267
(DOI:10.1159/000242428)

Fluoroquinolone-Resistant Pseudomonas aeruginosa in Chronic Rhinosinusitis

Guss J.a · Doghramji L.a · Edelstein P.H.b · Chiu A.G.a
aDepartment of Otorhinolaryngology, Head and Neck Surgery, and bDepartment of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pa., USA

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: July 02, 2009
Accepted: July 07, 2009
Published online: September 30, 2009
Issue release date: November 2009

Number of Print Pages: 5
Number of Figures: 0
Number of Tables: 3

ISSN: 0301-1569 (Print)
eISSN: 1423-0275 (Online)

For additional information: http://www.karger.com/ORL

Abstract

Background:Pseudomonas aeruginosa is cultured in nearly 1 of 5 patients with chronic rhinosinusitis and a history of sinus surgery. Fluoroquinolones are the only enterally administered antibiotics with efficacy against P. aeruginosa, but their frequent empiric use in the community raises concern for a rise in resistance. Objective: It was the aim of this study to determine the prevalence of fluoroquinolone-resistant P. aeruginosa in a tertiary rhinology practice. Methods: All bacterial sinus culture results from the outpatient otolaryngology clinic that yielded P. aeruginosa over a 5-year period (2002–2007) were reviewed along with the medical records of a randomly selected subset of patients. Results: In total, 689 culture results of 324 patients were examined. Nearly all patients had a history of endoscopic sinus surgery. Of all P. aeruginosa cultured, 13% were resistant to levofloxacin and 5% were intermediately sensitive, while 5% were resistant to ciprofloxacin and 7% intermediately sensitive. Of the 324 patients in the study, 19 and 15% had a history of a P. aeruginosa culture resistant to levofloxacin or ciprofloxacin, respectively. Mucoid strains of P. aeruginosa were significantly more likely to be fluoroquinolone resistant. No patient comorbidities were associated with a higher rate of resistance. The prevalence of resistant cultures remained stable over the 5-year study period. Conclusions:P. aeruginosa is cultured primarily in patients with previous sinus surgery. Nearly 20% of isolates are resistant to fluoroquinolones. Resistance to levofloxacin is more common than resistance to ciprofloxacin. This study supports the use of culture-directed therapy in the management of the postfunctional endoscopic sinus surgery patient and the avoidance of empiric use of fluoroquinolones.

© 2009 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: July 02, 2009
Accepted: July 07, 2009
Published online: September 30, 2009
Issue release date: November 2009

Number of Print Pages: 5
Number of Figures: 0
Number of Tables: 3

ISSN: 0301-1569 (Print)
eISSN: 1423-0275 (Online)

For additional information: http://www.karger.com/ORL


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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