Previous use of systemic antibiotics and oral corticosteroids for chronic rhinosinusitis predicts future utilization

Objective:

Utilization of antibiotics and systemic corticosteroids for chronic rhinosinusitis (CRS) is indicative of acute CRS exacerbations. We sought to determine if past utilization of these systemic medications would be predictive of future use.

Methods:

Prospective observational study of 150 patients undergoing medical management for CRS. Data collected at two time points: at enrollment and at follow-up 3 to 12 months later. All patients were asked to report the number of CRS-related antibiotics and oral corticosteroids they had used in the last 3 months. CRS symptom severity measured using the 22-item Sinonasal Outcome Test (SNOT-22). Associations were sought between use of CRS-related antibiotics and oral corticosteroids at follow up compared to enrollment, controlling for CRS symptom severity as well as clinical and demographic characteristics.

Results:

The number of CRS-related antibiotics used at follow up was associated with reported CRS-related antibiotic usage at enrollment (adjusted rate ratio [RR]= 1.58, 95%CI: 1.17 – 2.13, p = 0.003). The number of CRS-related oral corticosteroids used at follow up was associated with reported CRS-related antibiotic usage at enrollment (adjusted RR = 3.20, 95%CI: 1.69 – 6.07, p < 0.001). CRS-related antibiotics use was not predictive of oral corticosteroids use and vice versa. SNOT-22 at enrollment was also not predictive of future medication usage.

Conclusions:

Previous utilization of systemic medications is associated with future use of these medications. Since utilization of antibiotics and systemic corticosteroids for CRS is indicative of acute CRS exacerbations, these results show that certain patients may be prone to exacerbations regardless of medical management. Future studies should focus on characterizing these patients.

Publication History

Publication Date:
18 April 2018 (online)