Skip Navigation LinksHome > February 2014 - Volume 22 - Issue 1 > When and how should we treat biofilms in chronic sinusitis?
Current Opinion in Otolaryngology & Head & Neck Surgery:
doi: 10.1097/MOO.0000000000000010
NOSE AND PARANASAL SINUSES: Edited by Samuel S. Becker and Nithin D. Adappa

When and how should we treat biofilms in chronic sinusitis?

Jain, Ravi; Douglas, Richard

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Abstract

Purpose of review

Biofilms have been observed on the sinus mucosa of patients with chronic rhinosinusitis and are associated with poor clinical outcomes after surgery. This article summarizes the recent studies which describe the efficacy of treating biofilms in chronic rhinosinusitis.

Recent findings

Biofilms are polymicrobial communities comprised of bacteria that tend to be more antibiotic-resistant than when in planktonic forms. Antibiotic therapy against biofilms is usually associated with relapse following cessation of treatment and may also have an adverse effect on normal commensal microflora. Surfactants can improve clinical symptoms, but their use has been limited by side effects. Other treatment modalities that physically remove or disrupt biofilms, such as ultrasound, have shown some efficacy in small trials. The impact of surgery on biofilms has not been extensively investigated.

Summary

The nature of biofilms makes their removal difficult. No currently available treatment directed against them has demonstrated lasting efficacy.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

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