Jewish World Review Dec. 30, 2002 / 25 Teves, 5763

Inhaled antibiotic helps sinus sufferers

By Katrina Woznicki | (UPI) Patients suffering from chronic sinus infections who have not benefited from standard drugs or surgery can experience significant improvement by inhaling antibiotics, a new study released Thursday suggests.

Researchers led by Dr. Winston Vaughan, an otolaryngologist, sinus surgeon and director of the sinus center at Stanford University Medical Center in Palo Alto, Calif. studied 42 people who all suffered recurrent sinus infections even after undergoing surgery to their nasal passages.

The study, which is reported in the December issue of the journal Otolaryngology, was conduced over a 12-month period beginning in November 2000. Patients were given inhaled antibiotics twice a day for three weeks. All of them experienced improvements and 76 percent reported dramatic improvements, including fewer sinus headaches and less congestion. Study participants also reported less fatigue.

The researchers examined the patients' sinuses via endoscopies to confirm their testimony. Overall, the patients remained free of infection for an average of 17 weeks compared with only six weeks when taking antibiotic pills to treat their sinusitis.

"Traditional treatments were not compared to the inhaled treatments side by side," Vaughan told United Press International. "What we showed was that it (the inhaled antibiotics) increased their infection-free period."

It is unclear why this inhaled medication worked so effectively, but Vaughan said oral tablets that have to go through the gastrointestinal system might not provide as much treatment to the sinuses as needed.

"Portions (of the drug) may not get into the sinuses and especially in patients with scarred or abnormal tissues in the sinuses," he said. "Intravenous therapy probably works just as well as this does, but we don't know because it wasn't done side by side."

Side effects from inhaled antibiotics included sore throat and cough. Vaughan said adverse events were more common among individuals with asthma. Researchers advised patients to gargle after inhaling the treatment to help break up mucus.

Although inhaled medication has been widely available for asthma patients for many years, inhaled antibiotics have been on the market only for two to three years, Vaughan said. Sinusitis is a common ailment, afflicting more than 35 million Americans.

However, Vaughan said this type of treatment would not become a mainstream therapy for congested patients and would be recommended only to a small group of patients who have not benefited from sinus surgery or standard oral antibiotic treatment.

"It's another technique and a new technique," Dr. Kenneth F. Garay, director of the Center for Sinus and Nasal Disease in New York, an otolaryngologist and fellow of the American College of Surgeons, told UPI. "It's not for the person with the common cold or for the person who's had an infection once or twice. This is the treatment of last resort."

Many factors can make a person vulnerable to sinusitis including allergies, structural changes in the nose that could affect how the nasal passages drain mucus, fungal infections, and polyps in the nose, Garay explained. "The study of sinusitis is still an ongoing project," he said. "This treatment is in its infancy."

Vaughan chairs the scientific advisory board of a company called SinusPharmacy Corp., the corporation that developed the inhaled medication used in the study. Stanford University solely funded the research.

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© 2002, United Press International