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№3(6) 2023

Укр

DOI 10.37219/2528-8253-2023-3-74

Deyeva JuV

COMPLICATIONS OF RHINOSINUSITIS. STEP THERAPY

 

Dieieva Julia V
Bogomolets National Medical University, Kyiv, Ukraine
Head of the department of Otorhinolaryngology
MD, PhD, professor
E-mail: deyeva@bigmir.net
ORCID ID: 0000-0003-0552-1254
https://www.scopus.com/authid/detail.uri?authorId=55359076200

Abstract

Introduction: Acute rhinosinusitis is one of the most common conditions which a number of specialists – family doctors, pediatricians, therapists, otolaryngologists – meet at the primary appointments on a daily basis. However, despite the availability of various foreign clinical guidelines, in particular EPOS 2020, irrational antibiotic therapy in regards with this pathology is a serious problem. At the same time, the frequency of complications of rhinosinusitis in the total number of pathologies did not undergo special changes. The article will discuss foreign guidelines for the treatment of acute bacterial rhinosinusitis, their complications, and give an example of a clinical case of a complication of rhinosinusitis.

Purpose: To conduct a review of the available modern materials devoted to the problem of acute bacterial rhinosinusitis, complications of rhinosinusitis, and features of antibiotic therapy for these conditions.

Conclusions: Early diagnosis and standardized treatment of acute bacterial rhinosinusitis can reduce the risk of complications. Despite the latest guidelines and recommendations, the prescription of antibacterial agents for the treatment of acute bacterial rhinosinusitis remains a decision of each individual doctor. At the same time, when choosing a means of etiotropic therapy, it is necessary to follow a “graded approach”, where the penicillin group is the first-line antibiotic. Second line – cephalosporins, fluoroquinolones (Moflaxa), macrolides. And with the appearance of complications of rhinosinusitis, powerful drug therapy is necessary, which includes a number of means for parenteral administration. Antibiotic therapy of complications of rhinosinusitis requires the prescription of several agents at the same time, one of which is respiratory fluoroquinolones – moxifloxacin appropriate to use.

Key words: Acute rhinosinusitis, antibiotic therapy, complications, fluoroquinolones.

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