Nebulized Antibiotics for the Treatment of Refractory Bacterial Chronic Rhinosinusitis

OBJECTIVE:To review the safety and efficacy of nebulized antibiotics for refractory bacterial chronic rhinosinusitis (CRS) in adults.DATA SOURCES:PubMed (up to February 2011) and The Cochrane Library (up to February 2011) were searched using the terms nebulizer, nebulized, antibiotics, and chronic sinusitis.STUDY SELECTION AND DATA EXTRACTION:All English-language articles reporting clinical trials in adults were evaluated; 4 relevant studies were identified.DATA SYNTHESIS:Conventional therapy for CRS, including pharmacologic treatments (eg, oral antibiotics, corticosteroids, antihistamines) and surgery, are not effective for all patients, which has led to experimentation with nebulized antibiotics. The 4 trials analyzing the effectiveness of nebulized antibiotics for refractory CRS in adults identified in our literature search were diverse in their methods, and different antibiotics were used in each trial. Furthermore, all of the trials had small sample sizes, with the largest comprising 42 patients. Two...