Ostre zapalenie zatok – Epidemiologia

Ostre zapalenie zatok
Epidemiologia

Ostre zapalenie zatok (OZZ) jest powszechną jednostką kliniczną, dotykającą około 10-16% populacji dorosłych rocznie, z zapadalnością sięgającą 15-40 epizodów na 1000 pacjentów rocznie. Choroba wykazuje wyraźną sezonowość, z największą częstością występowania od jesieni do wiosny, co koreluje z infekcjami wirusowymi górnych dróg oddechowych, głównie rhinowirusami i koronawirusami. OZZ częściej dotyka kobiety (20,3%) niż mężczyzn (11,5%), a ryzyko zmniejsza się z wiekiem. Etiologia obejmuje głównie ostre wirusowe zapalenie zatok (90-98% przypadków u dorosłych), z niewielkim odsetkiem przejścia do bakteryjnego zapalenia zatok (0,5-2% u dorosłych, 5-10% u dzieci). Najczęstszymi patogenami bakteryjnymi są Streptococcus pneumoniae i Haemophilus influenzae, zwłaszcza w zakażeniach pozaszpitalnych. Czynniki ryzyka obejmują palenie tytoniu, starszy wiek, astmę, czynniki odontogenne i jatrogenne, niedobory odporności oraz przeszkody anatomiczne.

Epidemiologia ostrego zapalenia zatok

Ostre zapalenie zatok (OZZ) jest jedną z najczęściej diagnozowanych chorób w praktyce klinicznej. Szacuje się, że dotyka około 1 na 7-8 dorosłych osób rocznie, co stanowi około 10-16% populacji ogólnej ¹²³. W samych Stanach Zjednoczonych rocznie diagnozuje się około 30-35 milionów przypadków ostrego zapalenia zatok ⁴⁵⁶. W Wielkiej Brytanii ostre zapalenie zatok dotyka około 3 na 1000 osób ⁷. W Europie ocenia się, że 1-2 na 100 konsultacji w podstawowej opiece zdrowotnej dotyczy ostrego zapalenia zatok ⁸⁹.

Różnice demograficzne

Ostre zapalenie zatok częściej występuje u kobiet niż u mężczyzn, z częstością odpowiednio 20,3% i 11,5% ¹⁰. Wyższa częstość występowania u kobiet może być związana z ich częstszym kontaktem z małymi dziećmi ¹¹. Choć ostre zapalenie zatok może dotykać osoby w każdym wieku, najczęściej występuje między 5. a 7. dekadą życia ¹²¹³. Co interesujące, badanie Hoffmansa i współpracowników wykazało, że ryzyko ostrego zapalenia zatok zmniejsza się wraz z wiekiem ¹⁴.

Sezonowość

Występowanie ostrego zapalenia zatok wykazuje wyraźną sezonowość. Najwyższa zapadalność przypada na okres od wczesnej jesieni do wczesnej wiosny, co jest związane z sezonowością wirusowych infekcji górnych dróg oddechowych ¹⁵¹⁶¹⁷. Infekcje rhinowirusowe są najczęstsze jesienią i wiosną, podczas gdy infekcje koronawirusowe występują głównie od grudnia do marca ¹⁸.

Ostre zapalenie zatok – kategorie i etiologia

Ostre zapalenie zatok można podzielić na kilka kategorii etiologicznych, z których najczęstsze to ostre wirusowe zapalenie zatok i ostre bakteryjne zapalenie zatok.

Ostre wirusowe zapalenie zatok

Ostre wirusowe zapalenie zatok, czyli tzw. przeziębienie, jest niezwykle częstą chorobą – średnio występuje 2-5 razy rocznie u dorosłych i do 10 razy rocznie u dzieci ¹⁹. U dorosłych wirusy są przyczyną aż 90-98% wszystkich przypadków ostrego zapalenia zatok ²⁰²¹. Przeciętny dorosły ma 2-3 wirusowe infekcje górnych dróg oddechowych rocznie, a 90% przeziębień wiąże się z wirusowym zapaleniem zatok ²².

Ostre bakteryjne zapalenie zatok

Szacuje się, że jedynie 0,5-2% przypadków wirusowego zapalenia zatok u dorosłych rozwija się w infekcje bakteryjne, podczas gdy u dzieci odsetek ten wynosi 5-10% ²³²⁴. Według innych źródeł, około 0,5% wszystkich infekcji górnych dróg oddechowych jest powikłanych zapaleniem zatok, a zapadalność na ostre zapalenie zatok waha się od 15 do 40 epizodów na 1000 pacjentów rocznie, w zależności od środowiska ²⁵.

W przypadkach ostrego bakteryjnego zapalenia zatok u dorosłych, najczęstszymi patogenami są Streptococcus pneumoniae i Haemophilus influenzae, co zostało potwierdzone w badaniach materiału uzyskanego podczas punkcji zatoki szczękowej ²⁶. U pacjentów z zakażeniami szpitalnymi, częściej występują zakażenia bakteriami Gram-ujemnymi ²⁷.

Powiązane czynniki ryzyka

Główne czynniki ryzyka rozwoju ostrego zapalenia zatok obejmują ²⁸:

Palenie tytoniu
Starszy wiek
Podróże lotnicze
Nurkowanie głębinowe
Pływanie
Astmę

²⁹

Według wytycznych EPOS2020, czynniki zwiększające ryzyko bakteryjnego ostrego zapalenia zatok to ³⁰:

Czynniki odontogenne: infekcje i zabiegi chirurgiczne
Czynniki jatrogenne: operacje zatok, zgłębniki nosowo-żołądkowe, tamponada nosa, wentylacja mechaniczna
Niedobory odporności: HIV, niedobory immunoglobulin
Pierwotne i wtórne upośledzenie rzęsek: mukowiscydoza, pierwotna dyskineza rzęsek (zespół Kartagenera)
Palenie tytoniu
Wtórne zespoły nieruchomych rzęsek (poinfekcyjne, uszkodzenia po narażeniu na szkodliwe czynniki)
Przeszkody strukturalne/mechaniczne: skrzywienie przegrody nosowej, polipy nosa, przerost małżowin, guzy, urazy, ciała obce, ziarniniakowatość z zapaleniem naczyń
Obrzęk błony śluzowej: poprzedzająca wirusowa infekcja górnych dróg oddechowych, alergiczny nieżyt nosa, inne rodzaje nieżytu nosa

³¹

Znaczenie kliniczne i ekonomiczne

Koszty i obciążenie systemu opieki zdrowotnej

Ostre zapalenie zatok stanowi znaczące obciążenie ekonomiczne dla systemów opieki zdrowotnej. W Stanach Zjednoczonych roczne koszty leczenia zapalenia zatok oszacowano na ponad 11 miliardów dolarów, z czego około 3 miliardy dolarów przeznaczane są na ostre zapalenie zatok ³²³³. Według innych źródeł, w 1996 roku Amerykanie wydali około 3,39 miliarda dolarów na leczenie zapalenia zatok, a samo obciążenie ekonomiczne związane z ostrym zapaleniem zatok u dzieci wynosi 1,77 miliarda dolarów rocznie ³⁴.

Ostre zapalenie zatok jest piątą najczęstszą przyczyną wypisywania antybiotyków, odpowiadając za około 0,4% wszystkich diagnoz ambulatoryjnych ³⁵. Zapalenie zatok odpowiada za około 1 na 5 recept antybiotykowych dla dorosłych ³⁶³⁷. W 2002 roku 9% pediatrycznych recept na antybiotyki i 18% recept dla dorosłych zostało wystawionych z diagnozą ostrego zapalenia zatok ³⁸.

Nadużywanie antybiotyków

Pomimo faktu, że 70% pacjentów z ostrym zapaleniem zatok poprawia się bez antybiotyków, pozostaje ono piątym najczęstszym wskazaniem do przepisywania leków przeciwbakteryjnych przez lekarzy ³⁹. W Europie i Ameryce Północnej ponad 90% pacjentów z diagnozą ostrego zapalenia zatok w podstawowej opiece zdrowotnej otrzymuje recepty na antybiotyki, mimo samoograniczającego się charakteru zakażeń zatok i wyników wielu badań klinicznych, które pokazują, że większość pacjentów w grupach placebo poprawia się prawie tak szybko jak ci, którzy otrzymują leczenie antybiotykami ⁴⁰.

Badanie oceniające zasadność przepisywania antybiotyków na ostre zapalenie zatok wykazało, że aż 81% recept na antybiotyki dla pacjentów z ostrym zapaleniem zatok było nieodpowiednich. Najczęstsze błędy w przepisywaniu obejmowały brak wskazań do antybiotykoterapii i nadmierny czas jej trwania, co występowało w około 50% przypadków zapalenia zatok ⁴¹.

Powikłania i specjalne populacje pacjentów

Powikłania ostrego zapalenia zatok

Powikłania ostrego bakteryjnego zapalenia zatok są bardzo rzadkie – nie występowały w grupach placebo w badaniach klinicznych antybiotyków prowadzonych w podstawowej opiece zdrowotnej ⁴². Jednak nieleczone ostre zapalenie zatok może prowadzić do różnych powikłań i wymaga dłuższego kursu antybiotyków dla uzyskania poprawy ⁴³.

Ostre zapalenie zatok w szczególnych populacjach

Ostre zapalenie zatok w populacji pacjentów oddziałów intensywnej terapii stanowi odrębną jednostkę, występującą u 18-32% pacjentów z przedłużonymi okresami intubacji, i zwykle jest diagnozowane podczas oceny niewyjaśnionej gorączki ⁴⁴.

Rhinocerebralne mucormykoza występuje u pacjentów z obniżoną odpornością, w tym u pacjentów z cukrzycą i kwasicą ketonową, biorców przeszczepów, pacjentów z nowotworami hematologicznymi oraz pacjentów leczonych przewlekle glikokortykosteroidami lub deferoksaminą. Wskaźniki śmiertelności w mucormykozie wynoszą od 30% do 70%. Wskaźnik śmiertelności u pacjentów z cukrzycą wydaje się być niższy niż u pacjentów bez cukrzycy i u pacjentów z zajęciem wewnątrzmózgowym. Wskaźniki przeżycia są najwyższe, gdy odstęp od diagnozy do leczenia jest krótszy niż 6 dni ⁴⁵.

Nowe trendy i badania

Wpływ szczepień na epidemiologię

Wprowadzenie 13-walentnej szczepionki przeciwko pneumokokom (PCV13) przyczyniło się do zmniejszenia częstości występowania ostrego zapalenia zatok. Badania wykazały, że w latach 2000-2018 ogólna zapadalność na ostre zapalenie zatok we wszystkich grupach wiekowych spadła o 18% (z 33 do 27 na 1000 osób), przy czym spadki obserwowano we wszystkich grupach wiekowych z wyjątkiem osób powyżej 65 roku życia ⁴⁶. W związku z okresem po wprowadzeniu PCV13, występowanie ostrego zapalenia zatok zmniejszyło się (współczynnik częstości występowania [IRR] wyniósł 0,88) ⁴⁷.

Ogólnie wykorzystanie antybiotyków zmniejszyło się w okresie po wprowadzeniu PCV13 (IRR wyniósł 0,65). Badanie to potwierdza wcześniejsze wyniki pokazujące, że PCV13 zmniejsza częstość występowania ostrego zapalenia zatok, a także podkreśla często niedocenianą dodatkową korzyść ze szczepień: mniejszą liczbę recept na antybiotyki w przypadku tych infekcji ⁴⁸.

Wyzwania w diagnostyce

Infekcje zatok pozostają głównym powodem, dla którego pacjentom przepisuje się antybiotyki, których nie potrzebują. Może to wynikać z braku wystarczających wytycznych dla klinicystów dotyczących tego, które objawy i oznaki dokładnie wskazują na bakteryjne zapalenie zatok ⁴⁹.

Badanie przeprowadzone przez Uniwersytet w Georgii analizowało istniejącą literaturę medyczną dotyczącą diagnostyki zakażenia zatok. „Dane na temat klinicznego diagnozowania zapalenia zatok nie są najlepsze”, stwierdził dr Mark Ebell, profesor epidemiologii i biostatystyki z College of Public Health UGA i główny autor badania. „Stwierdziliśmy, że nie ma zbyt wielu danych dotyczących poszczególnych objawów i symptomów” ⁵⁰.

Tylko jedna na trzy infekcje zatok jest spowodowana przez bakterie, ale prawie trzech na czterech pacjentów otrzymuje antybiotyki do leczenia swojej choroby. W dobie rosnącej oporności na antybiotyki, ta rozbieżność między przepisywaniem a potrzebą stanowi problem ⁵¹.

W badaniu opublikowanym w Annals of Family Medicine, Ebell i jego współautorzy starali się zidentyfikować, czy określone objawy, takie jak kaszel, ból głowy lub przebarwiona wydzielina, najlepiej przewidują obecność bakteryjnego zapalenia zatok. Stwierdzili, że ogólne wrażenie klinicysty dotyczące objawów pacjenta, które opiera się na doświadczeniu i ocenie lekarza, było najdokładniejszą metodą diagnozy. Skargi pacjenta na nieprzyjemny zapach i ból w górnych zębach były odpowiednio drugim i trzecim najdokładniejszym objawem zakażenia zatok ⁵².

Typ ostrego zapalenia zatok	Częstość występowania	Populacja	Źródło
Ostre wirusowe zapalenie zatok (przeziębienie)	2-5 epizodów rocznie Do 10 epizodów rocznie	Dorośli Dzieci	EPOS
Ostre powirusowe zapalenie zatok	18% (17-21%)	Populacja ogólna	Hoffmans et al.
Ostre bakteryjne zapalenie zatok	0,5-2% 5-10%	Dorośli z wirusowym zapaleniem zatok Dzieci z wirusowym zapaleniem zatok	StatPearls
Ostre zapalenie zatok – ogólnie	1 na 7-8 dorosłych 10-16% populacji 15-40 epizodów/1000 pacjentów/rok	Populacja ogólna Populacja ogólna W zależności od środowiska	Multiple sources

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Materiały źródłowe

#1 Pulsenotes | Acute rhinosinusitis
https://app.pulsenotes.com/surgery/ent/notes/acute-rhinosinusitis
Acute rhinosinusitis is a common problem that can affect up to 1 in 7 patients per year. […] In Europe, 1-2 per 100 general practice consultations are due to acute rhinosinusitis. The incidence is higher in women and can affect all ages, although it most commonly occurs in the 5-7th decades. Major risk factors for developing acute rhinosinusitis include smoking, older age, air travel, deep sea diving, swimming and asthma.
#2 Acute Sinusitis: Practice Essentials, Background, Anatomy
https://emedicine.medscape.com/article/232670-overview
Sinusitis affects 1 out of every 7 adults in the United States, with more than 30 million individuals diagnosed each year. Sinusitis is more common from early fall to early spring. Rhinosinusitis affects an estimated 35 million people per year in the United States and accounts for close to 16 million office visits per year. […] According to the National Ambulatory Medical Care Survey (NAMCS), approximately 14% of adults report having an episode of rhinosinusitis each year, and it is the fifth most common diagnosis for which antibiotics are prescribed, accounting for 0.4% of ambulatory diagnoses. […] In 1996, Americans spent approximately $3.39 billion treating rhinosinusitis. The economic burden of acute sinusitis in children is $1.77 billion per year. […] Acute sinusitis affects 3 in 1000 people in the United Kingdom. Chronic sinusitis affects 1 in 1000 people. Sinusitis is more common in winter than in summer. Rhinoviral infections are prevalent in autumn and spring. Coronaviral infection occurs mostly from December to March.
#3 Medical Treatment for Acute Sinusitis: Practice Essentials, Pathophysiology, Epidemiology
https://emedicine.medscape.com/article/861646-overview
About 1 out of every 8 adults in the United States is affected by sinusitis, either acute or chronic. […] Acute sinusitis in the intensive care population is a distinct entity, occurring in 18-32% of patients with prolonged periods of intubation, and is usually diagnosed during the evaluation of unexplained fever.
#4 Sinusitis Epidemiology Forecast 2034
https://www.expertmarketresearch.com/epidemiology-reports/sinusitis-epidemiology-forecast
The sinusitis epidemiology division offers information on the patient pool from history to the present as well as the projected trend for each of the 8 major markets. […] About 30 million persons in the United States alone suffer from sinusitis each year. […] According to the Centers for Disease Control and Prevention, around 11% of adults in the United States suffer with chronic rhinosinusitis. […] Depending on the duration of symptoms, sinusitis is categorized as acute and subacute. For acute sinusitis, the symptoms persist for less than four weeks and often go away entirely. […] Acute sinusitis is caused by a virus in 50% to 70% of pediatric cases and almost 90% of adult cases. […] The sinusitis epidemiology data and findings from the United States, Germany, Spain, Italy, France, the United Kingdom, Japan, and India are also provided in the epidemiology section. […] The chronic sinusitis affects an estimated 134 million Indians, include fever, nasal congestion and blockage, and incapacitating headaches.
#5 Sinusitis – Knowledge @ AMBOSS
https://www.amboss.com/us/knowledge/sinusitis/
Incidence: Sinusitis is one of the most commonly diagnosed conditions in the USA, affecting an estimated 35 million individuals per year. […] Peak incidence: early fall to early spring. […] Epidemiological data refers to the US, unless otherwise specified.
#6
https://www.atsu.edu/faculty/chamberlain/website/lectures/lecture/urisin.htm
Acute rhinosinusitis occurs in about 32 million people each year in the US. […] In approximately 2% of adults and 10% of children, acute bacterial rhinosinusitis can follow acute viral rhinosinusitis, allergic rhinitis, or other upper respiratory tract infections. […] Patients with hospital-acquired infections are more likely to be infected with gram-negative organisms when they develop acute bacterial rhinosinusitis. […] Rhinocerebral mucormycosis occurs in immunocompromised patients that include diabetic patients with ketoacidosis, transplant recipients, patients with hematologic malignancies, and patients on chronic glucocorticoid or deferoxamine therapy. […] Mortality rates are from 30-70%. The mortality rate in diabetic patients appears to be lower than in nondiabetic patients and in patients with intracerebral involvement. […] Survival rates are highest when the interval from diagnosis to treatment is less than 6 days.
#7 Acute Sinusitis: Practice Essentials, Background, Anatomy
https://emedicine.medscape.com/article/232670-overview
Sinusitis affects 1 out of every 7 adults in the United States, with more than 30 million individuals diagnosed each year. Sinusitis is more common from early fall to early spring. Rhinosinusitis affects an estimated 35 million people per year in the United States and accounts for close to 16 million office visits per year. […] According to the National Ambulatory Medical Care Survey (NAMCS), approximately 14% of adults report having an episode of rhinosinusitis each year, and it is the fifth most common diagnosis for which antibiotics are prescribed, accounting for 0.4% of ambulatory diagnoses. […] In 1996, Americans spent approximately $3.39 billion treating rhinosinusitis. The economic burden of acute sinusitis in children is $1.77 billion per year. […] Acute sinusitis affects 3 in 1000 people in the United Kingdom. Chronic sinusitis affects 1 in 1000 people. Sinusitis is more common in winter than in summer. Rhinoviral infections are prevalent in autumn and spring. Coronaviral infection occurs mostly from December to March.
#8 Treating acute sinusitis – Australian Prescriber
https://australianprescriber.tg.org.au/articles/treating-acute-sinusitis-3.html
Symptoms of rhinosinusitis are prevalent in 16% of the general population. Acute sinusitis accounts for up to 4.6% of consultations with young adults. Approximately 0.5% of common colds are complicated by sinusitis and the average number of colds for an adult per year is 2-3, so many patients will present with signs and symptoms of sinusitis. […] Acute sinusitis usually follows an acute upper respiratory tract infection (common cold). […] The gold standard for the diagnosis of acute bacterial sinusitis remains aspiration of pus from one of the major sinuses. […] Acute sinusitis is thought to be caused by the secondary bacterial invasion of inflamed sinuses that can occur in an acute viral upper respiratory tract infection. […] Most cases of acute sinusitis can be managed by the general practitioner. However, referral should occur if complications develop or if the patient fails to respond to second-line therapy. Referral should also be made for patients with recurrent acute sinusitis.
#9 Pulsenotes | Acute rhinosinusitis
https://app.pulsenotes.com/surgery/ent/notes/acute-rhinosinusitis
Acute rhinosinusitis is a common problem that can affect up to 1 in 7 patients per year. […] In Europe, 1-2 per 100 general practice consultations are due to acute rhinosinusitis. The incidence is higher in women and can affect all ages, although it most commonly occurs in the 5-7th decades. Major risk factors for developing acute rhinosinusitis include smoking, older age, air travel, deep sea diving, swimming and asthma.
#10 Acute Sinusitis: Practice Essentials, Background, Anatomy
https://emedicine.medscape.com/article/232670-overview
An average child is likely to have 6-8 colds (ie, upper respiratory tract infections) per year, and approximately 0.5-2% of upper respiratory tract infections in adults and 6-13% of viral upper respiratory tract infections in children are complicated by the development of acute bacterial sinusitis. […] Women have more episodes of infective sinusitis than men because they tend to have more close contact with young children. The rate in women is 20.3%, compared with 11.5% in men.
#11 Acute Sinusitis: Practice Essentials, Background, Anatomy
https://emedicine.medscape.com/article/232670-overview
An average child is likely to have 6-8 colds (ie, upper respiratory tract infections) per year, and approximately 0.5-2% of upper respiratory tract infections in adults and 6-13% of viral upper respiratory tract infections in children are complicated by the development of acute bacterial sinusitis. […] Women have more episodes of infective sinusitis than men because they tend to have more close contact with young children. The rate in women is 20.3%, compared with 11.5% in men.
#12 Pulsenotes | Acute rhinosinusitis
https://app.pulsenotes.com/surgery/ent/notes/acute-rhinosinusitis
Acute rhinosinusitis is a common problem that can affect up to 1 in 7 patients per year. […] In Europe, 1-2 per 100 general practice consultations are due to acute rhinosinusitis. The incidence is higher in women and can affect all ages, although it most commonly occurs in the 5-7th decades. Major risk factors for developing acute rhinosinusitis include smoking, older age, air travel, deep sea diving, swimming and asthma.
#13 Sinusitis | Concise Medical Knowledge
https://www.lecturio.com/concepts/sinusitis/
Higher incidence Incidence The number of new cases of a given disease during a given period in a specified population. It also is used for the rate at which new events occur in a defined population. It is differentiated from prevalence, which refers to all cases in the population at a given time. Measures of Disease Frequency in women and in those aged 4564 years.
#14 Acute sinusitis in daily clinical practice
https://otolaryngologypl.com/article/01.3001.0015.2378/en?language=pl
EPOS2020 also summarized when the risk of bacterial ARS increases, listing the following predisposing factors for a bacterial infection: odontogenic: infections and surgical procedures, iatrogenic: sinus surgery, nasogastric tubes, nasal packing, mechanical ventilation, immunodeficiencies: HIV, immunoglobulin deficiencies, primary and secondary ciliary impairment: cystic fibrosis, primary ciliary dyskinesis (Kartagener syndrome), smoking, secondary immotile cilia syndromes (post-infectious, damage after exposure to harmful factors), structural/mechanical obstruction: deviated nasal septum (DNS), nasal polyps, hypertrophic turbinates, tumors, trauma, foreign bodies, GPA, mucosal edema: preceding viral upper respiratory infection, allergic rhinitis, other rhinitis. What is interesting, according to the Hoffmans et al. study the risk of ARS decreases with age.
#15 Sinusitis – Knowledge @ AMBOSS
https://www.amboss.com/us/knowledge/sinusitis/
Incidence: Sinusitis is one of the most commonly diagnosed conditions in the USA, affecting an estimated 35 million individuals per year. […] Peak incidence: early fall to early spring. […] Epidemiological data refers to the US, unless otherwise specified.
#16 Acute Sinusitis: Practice Essentials, Background, Anatomy
https://emedicine.medscape.com/article/232670-overview
Sinusitis affects 1 out of every 7 adults in the United States, with more than 30 million individuals diagnosed each year. Sinusitis is more common from early fall to early spring. Rhinosinusitis affects an estimated 35 million people per year in the United States and accounts for close to 16 million office visits per year. […] According to the National Ambulatory Medical Care Survey (NAMCS), approximately 14% of adults report having an episode of rhinosinusitis each year, and it is the fifth most common diagnosis for which antibiotics are prescribed, accounting for 0.4% of ambulatory diagnoses. […] In 1996, Americans spent approximately $3.39 billion treating rhinosinusitis. The economic burden of acute sinusitis in children is $1.77 billion per year. […] Acute sinusitis affects 3 in 1000 people in the United Kingdom. Chronic sinusitis affects 1 in 1000 people. Sinusitis is more common in winter than in summer. Rhinoviral infections are prevalent in autumn and spring. Coronaviral infection occurs mostly from December to March.
#17 Sinusitis | 5-Minute Clinical Consult
https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116559/all/Sinusitis?q=Hypertension
Affects 1 in 8 adults (30 million people in the United States yearly diagnosed with rhinosinusitis) […] Acute bacterial rhinosinusitis remains the fifth leading reason for prescribing antibiotics. […] Viral cause in 90-98% of cases with 0.5-2% having a bacterial superinfection. […] Incidence is highest in early fall through early spring (related to the incidence of viral upper respiratory infection [URI]). Adults have 2 to 3 viral URIs per year; 90% of colds are accompanied by viral rhinosinusitis. It is the fifth most common diagnosis during family physician visits.
#18 Acute Sinusitis: Practice Essentials, Background, Anatomy
https://emedicine.medscape.com/article/232670-overview
Sinusitis affects 1 out of every 7 adults in the United States, with more than 30 million individuals diagnosed each year. Sinusitis is more common from early fall to early spring. Rhinosinusitis affects an estimated 35 million people per year in the United States and accounts for close to 16 million office visits per year. […] According to the National Ambulatory Medical Care Survey (NAMCS), approximately 14% of adults report having an episode of rhinosinusitis each year, and it is the fifth most common diagnosis for which antibiotics are prescribed, accounting for 0.4% of ambulatory diagnoses. […] In 1996, Americans spent approximately $3.39 billion treating rhinosinusitis. The economic burden of acute sinusitis in children is $1.77 billion per year. […] Acute sinusitis affects 3 in 1000 people in the United Kingdom. Chronic sinusitis affects 1 in 1000 people. Sinusitis is more common in winter than in summer. Rhinoviral infections are prevalent in autumn and spring. Coronaviral infection occurs mostly from December to March.
#19 Acute sinusitis in daily clinical practice
https://otolaryngologypl.com/article/01.3001.0015.2378/en?language=pl
The prevalence of ARS in the general population varies significantly in available studies. Acute viral rhinosinusitis, the common cold, is an extremely common illness â on average it occurs 2 to 5 times per year in adults and up to 10 times per year in children. […] In 2018, Hoffmans et al. published the latest Dutch study based on the EPOS criteria. Based on the results, the prevalence of post-viral ARS is estimated at 18% (17â21%). This subtype of sinusitis is also clearly associated with higher direct costs of treatment. […] Only about 0.5â2% of viral ARS cases progress to bacterial ARS. This means that, in practice, ABRS is over-diagnosed and indications for antibiotics are grossly overstated. […] Factors predisposing to ARS include anatomical abnormalities (especially in RARS), allergic rhinitis, immunodeficiencies, primary and secondary ciliary dyskinesia, active and passive smoking, air pollution (smog), gastro-esophageal reflux (controversial factor), anxiety and depressive disorders.
#20 Sinusitis | 5-Minute Clinical Consult
https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116559/all/Sinusitis?q=Hypertension
Affects 1 in 8 adults (30 million people in the United States yearly diagnosed with rhinosinusitis) […] Acute bacterial rhinosinusitis remains the fifth leading reason for prescribing antibiotics. […] Viral cause in 90-98% of cases with 0.5-2% having a bacterial superinfection. […] Incidence is highest in early fall through early spring (related to the incidence of viral upper respiratory infection [URI]). Adults have 2 to 3 viral URIs per year; 90% of colds are accompanied by viral rhinosinusitis. It is the fifth most common diagnosis during family physician visits.
#21 Sinusitis Epidemiology Forecast 2034
https://www.expertmarketresearch.com/epidemiology-reports/sinusitis-epidemiology-forecast
The sinusitis epidemiology division offers information on the patient pool from history to the present as well as the projected trend for each of the 8 major markets. […] About 30 million persons in the United States alone suffer from sinusitis each year. […] According to the Centers for Disease Control and Prevention, around 11% of adults in the United States suffer with chronic rhinosinusitis. […] Depending on the duration of symptoms, sinusitis is categorized as acute and subacute. For acute sinusitis, the symptoms persist for less than four weeks and often go away entirely. […] Acute sinusitis is caused by a virus in 50% to 70% of pediatric cases and almost 90% of adult cases. […] The sinusitis epidemiology data and findings from the United States, Germany, Spain, Italy, France, the United Kingdom, Japan, and India are also provided in the epidemiology section. […] The chronic sinusitis affects an estimated 134 million Indians, include fever, nasal congestion and blockage, and incapacitating headaches.
#22 Sinusitis | 5-Minute Clinical Consult
https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116559/all/Sinusitis?q=Hypertension
Affects 1 in 8 adults (30 million people in the United States yearly diagnosed with rhinosinusitis) […] Acute bacterial rhinosinusitis remains the fifth leading reason for prescribing antibiotics. […] Viral cause in 90-98% of cases with 0.5-2% having a bacterial superinfection. […] Incidence is highest in early fall through early spring (related to the incidence of viral upper respiratory infection [URI]). Adults have 2 to 3 viral URIs per year; 90% of colds are accompanied by viral rhinosinusitis. It is the fifth most common diagnosis during family physician visits.
#23 Acute Sinusitis | Treatment & Management | Point of Care
https://www.statpearls.com/point-of-care/29065
Acute rhinosinusitis accounts for 1 in 5 antibiotic prescriptions for adults, making it the fifth most common reason for an antibiotic prescription. Approximately 6% to 7% of children with respiratory symptoms have acute rhinosinusitis. An estimated 16% of adults are diagnosed with ABRS annually. Given the clinical nature of this diagnosis, there is a possibility of overestimation. […] An estimated 0.5 to 2.0% of viral rhinosinusitis (VRS) will develop into bacterial infections in adults and 5 to 10% in children.
#24 Acute sinusitis in daily clinical practice
https://otolaryngologypl.com/article/01.3001.0015.2378/en?language=pl
The prevalence of ARS in the general population varies significantly in available studies. Acute viral rhinosinusitis, the common cold, is an extremely common illness â on average it occurs 2 to 5 times per year in adults and up to 10 times per year in children. […] In 2018, Hoffmans et al. published the latest Dutch study based on the EPOS criteria. Based on the results, the prevalence of post-viral ARS is estimated at 18% (17â21%). This subtype of sinusitis is also clearly associated with higher direct costs of treatment. […] Only about 0.5â2% of viral ARS cases progress to bacterial ARS. This means that, in practice, ABRS is over-diagnosed and indications for antibiotics are grossly overstated. […] Factors predisposing to ARS include anatomical abnormalities (especially in RARS), allergic rhinitis, immunodeficiencies, primary and secondary ciliary dyskinesia, active and passive smoking, air pollution (smog), gastro-esophageal reflux (controversial factor), anxiety and depressive disorders.
#25 Acute sinusitis
https://pmc.ncbi.nlm.nih.gov/articles/PMC3093592/
Approximately 0.5% of all upper respiratory tract infections are complicated by sinusitis; the incidence of acute sinusitis ranges from 15 to 40 episodes per 1000 patients per year, depending on the setting. It is much more common in adults than it is in children, whose sinuses are not fully developed. Acute sinusitis is the second most common infectious disease seen by GPs. Most acute sinusitis is caused by the same viruses that cause the common cold. Although up to one-third of adult patients seen in ears, nose, and throat clinics might have acute bacterial sinusitis (and cultures of antral puncture specimens show Streptococcus pneumoniae and Haemophilus influenzae to be the most common causative bacteria), the proportion of cases of acute sinusitis due to bacteria is much smaller in primary care probably less than 2%.
#26 Acute sinusitis
https://pmc.ncbi.nlm.nih.gov/articles/PMC3093592/
Approximately 0.5% of all upper respiratory tract infections are complicated by sinusitis; the incidence of acute sinusitis ranges from 15 to 40 episodes per 1000 patients per year, depending on the setting. It is much more common in adults than it is in children, whose sinuses are not fully developed. Acute sinusitis is the second most common infectious disease seen by GPs. Most acute sinusitis is caused by the same viruses that cause the common cold. Although up to one-third of adult patients seen in ears, nose, and throat clinics might have acute bacterial sinusitis (and cultures of antral puncture specimens show Streptococcus pneumoniae and Haemophilus influenzae to be the most common causative bacteria), the proportion of cases of acute sinusitis due to bacteria is much smaller in primary care probably less than 2%.
#27
https://www.atsu.edu/faculty/chamberlain/website/lectures/lecture/urisin.htm
Acute rhinosinusitis occurs in about 32 million people each year in the US. […] In approximately 2% of adults and 10% of children, acute bacterial rhinosinusitis can follow acute viral rhinosinusitis, allergic rhinitis, or other upper respiratory tract infections. […] Patients with hospital-acquired infections are more likely to be infected with gram-negative organisms when they develop acute bacterial rhinosinusitis. […] Rhinocerebral mucormycosis occurs in immunocompromised patients that include diabetic patients with ketoacidosis, transplant recipients, patients with hematologic malignancies, and patients on chronic glucocorticoid or deferoxamine therapy. […] Mortality rates are from 30-70%. The mortality rate in diabetic patients appears to be lower than in nondiabetic patients and in patients with intracerebral involvement. […] Survival rates are highest when the interval from diagnosis to treatment is less than 6 days.
#28 Pulsenotes | Acute rhinosinusitis
https://app.pulsenotes.com/surgery/ent/notes/acute-rhinosinusitis
Acute rhinosinusitis is a common problem that can affect up to 1 in 7 patients per year. […] In Europe, 1-2 per 100 general practice consultations are due to acute rhinosinusitis. The incidence is higher in women and can affect all ages, although it most commonly occurs in the 5-7th decades. Major risk factors for developing acute rhinosinusitis include smoking, older age, air travel, deep sea diving, swimming and asthma.
#29 Pulsenotes | Acute rhinosinusitis
https://app.pulsenotes.com/surgery/ent/notes/acute-rhinosinusitis
Acute rhinosinusitis is a common problem that can affect up to 1 in 7 patients per year. […] In Europe, 1-2 per 100 general practice consultations are due to acute rhinosinusitis. The incidence is higher in women and can affect all ages, although it most commonly occurs in the 5-7th decades. Major risk factors for developing acute rhinosinusitis include smoking, older age, air travel, deep sea diving, swimming and asthma.
#30 Acute sinusitis in daily clinical practice
https://otolaryngologypl.com/article/01.3001.0015.2378/en?language=pl
EPOS2020 also summarized when the risk of bacterial ARS increases, listing the following predisposing factors for a bacterial infection: odontogenic: infections and surgical procedures, iatrogenic: sinus surgery, nasogastric tubes, nasal packing, mechanical ventilation, immunodeficiencies: HIV, immunoglobulin deficiencies, primary and secondary ciliary impairment: cystic fibrosis, primary ciliary dyskinesis (Kartagener syndrome), smoking, secondary immotile cilia syndromes (post-infectious, damage after exposure to harmful factors), structural/mechanical obstruction: deviated nasal septum (DNS), nasal polyps, hypertrophic turbinates, tumors, trauma, foreign bodies, GPA, mucosal edema: preceding viral upper respiratory infection, allergic rhinitis, other rhinitis. What is interesting, according to the Hoffmans et al. study the risk of ARS decreases with age.
#31 Acute sinusitis in daily clinical practice
https://otolaryngologypl.com/article/01.3001.0015.2378/en?language=pl
EPOS2020 also summarized when the risk of bacterial ARS increases, listing the following predisposing factors for a bacterial infection: odontogenic: infections and surgical procedures, iatrogenic: sinus surgery, nasogastric tubes, nasal packing, mechanical ventilation, immunodeficiencies: HIV, immunoglobulin deficiencies, primary and secondary ciliary impairment: cystic fibrosis, primary ciliary dyskinesis (Kartagener syndrome), smoking, secondary immotile cilia syndromes (post-infectious, damage after exposure to harmful factors), structural/mechanical obstruction: deviated nasal septum (DNS), nasal polyps, hypertrophic turbinates, tumors, trauma, foreign bodies, GPA, mucosal edema: preceding viral upper respiratory infection, allergic rhinitis, other rhinitis. What is interesting, according to the Hoffmans et al. study the risk of ARS decreases with age.
#32 Sinusitis – Wikipedia
https://en.wikipedia.org/wiki/Sinusitis
Sinusitis is a common condition, with between 24 and 31 million cases occurring in the United States annually. Chronic sinusitis affects approximately 12.5% of people. […] The management of sinusitis in the United States results in more than US$11 billion in costs.
#33 Recurrent Acute Rhinosinusitis | Treatment & Management | Point of Care
https://www.statpearls.com/point-of-care/35995
Sinusitis ranks among the most common conditions prompting medical attention, with 1 in 8 adults receiving a sinusitis diagnosis at least once in their lifetime. Sinusitis accounts for 20% of all antibiotic prescriptions. In the United States alone, in 2015, there were 30 million diagnosed sinusitis cases, incurring a substantial treatment cost exceeding $11 billion: $3 billion allocated to acute sinusitis and $8.3 billion to chronic sinusitis. A comprehensive review of a medical claims database encompassing 13.1 million people from 2003 to 2008 revealed a RARS prevalence of 1 in 3,000. Within this population, females constituted the majority (72.1%) of affected individuals, with a mean age of 43.5 years. On average, patients had 5.6 annual healthcare visits and filled 9.4 prescriptions per year, resulting in an annual direct cost burden of $1,091 per patient.
#34 Acute Sinusitis: Practice Essentials, Background, Anatomy
https://emedicine.medscape.com/article/232670-overview
Sinusitis affects 1 out of every 7 adults in the United States, with more than 30 million individuals diagnosed each year. Sinusitis is more common from early fall to early spring. Rhinosinusitis affects an estimated 35 million people per year in the United States and accounts for close to 16 million office visits per year. […] According to the National Ambulatory Medical Care Survey (NAMCS), approximately 14% of adults report having an episode of rhinosinusitis each year, and it is the fifth most common diagnosis for which antibiotics are prescribed, accounting for 0.4% of ambulatory diagnoses. […] In 1996, Americans spent approximately $3.39 billion treating rhinosinusitis. The economic burden of acute sinusitis in children is $1.77 billion per year. […] Acute sinusitis affects 3 in 1000 people in the United Kingdom. Chronic sinusitis affects 1 in 1000 people. Sinusitis is more common in winter than in summer. Rhinoviral infections are prevalent in autumn and spring. Coronaviral infection occurs mostly from December to March.
#35 Acute Sinusitis: Practice Essentials, Background, Anatomy
https://emedicine.medscape.com/article/232670-overview
Sinusitis affects 1 out of every 7 adults in the United States, with more than 30 million individuals diagnosed each year. Sinusitis is more common from early fall to early spring. Rhinosinusitis affects an estimated 35 million people per year in the United States and accounts for close to 16 million office visits per year. […] According to the National Ambulatory Medical Care Survey (NAMCS), approximately 14% of adults report having an episode of rhinosinusitis each year, and it is the fifth most common diagnosis for which antibiotics are prescribed, accounting for 0.4% of ambulatory diagnoses. […] In 1996, Americans spent approximately $3.39 billion treating rhinosinusitis. The economic burden of acute sinusitis in children is $1.77 billion per year. […] Acute sinusitis affects 3 in 1000 people in the United Kingdom. Chronic sinusitis affects 1 in 1000 people. Sinusitis is more common in winter than in summer. Rhinoviral infections are prevalent in autumn and spring. Coronaviral infection occurs mostly from December to March.
#36 Acute Sinusitis | Treatment & Management | Point of Care
https://www.statpearls.com/point-of-care/29065
Acute rhinosinusitis accounts for 1 in 5 antibiotic prescriptions for adults, making it the fifth most common reason for an antibiotic prescription. Approximately 6% to 7% of children with respiratory symptoms have acute rhinosinusitis. An estimated 16% of adults are diagnosed with ABRS annually. Given the clinical nature of this diagnosis, there is a possibility of overestimation. […] An estimated 0.5 to 2.0% of viral rhinosinusitis (VRS) will develop into bacterial infections in adults and 5 to 10% in children.
#37 Acute Rhinosinusitis – Core EM
https://coreem.net/core/acute-rhinosinusitis/
Epidemiology (Anon 2004) […] 20 million cases of sinusitis annually in the US, costing $3.5 billion/year […] Source of 1 in 5 antibiotic prescriptions for adults […] […] […] Acute rhinosinusitis is a clinical diagnosis […] The vast majority of acute rhinosinusitis cases are viral in nature and do not require antibiotics […] Consider the use of antibiotics in select groups with severe disease or worsening symptoms after initial improvement
#38 Acute & Chronic Sinusitis | Ento Key
https://entokey.com/acute-chronic-sinusitis/
Rhinosinusitis is one of the most commonly diagnosed medical conditions in the United States, affecting an estimated 16% of the adult population annually. Direct health care costs are significant, estimated to be over $5.8 billion per year. According to the recent 2007 data from the National Health Interview Survey, rhinosinusitis continues to be one of the top 10 leading diagnoses of office visits in the United States. Of all antibiotics prescribed in 2002, 9% of pediatric prescriptions and 18% of adult prescriptions were written for a diagnosis of acute sinusitis. […] Benninger MS, Ferguson BJ, Hadley JA. Adult chronic rhinosinusitis: definitions, diagnosis, epidemiology, and pathophysiology. Otolaryngol Head Neck Surg 2003 Sep;129(3 Suppl):S132. (This task force summarized the impact of CRS and proposed an updated definition in 2003.) […] Rosenfeld RM, Andes D, Bhattacharyya N et al. Clinical practice guideline on adult sinusitis. Otolaryngol Head Neck Surg. 2007 Sep;137(3):365377. (The most recent guidelines illustrating the current recommendations on the diagnosis and treatment of rhinosinusitis.)
#39 An Overview of the Treatment and Management of Rhinosinusitis
https://www.uspharmacist.com/article/an-overview-of-the-treatment-and-management-of-rhinosinusitis
The annual cost of sinusitis in the United States is approximately $5.8 billion, which includes over 500,000 surgical procedures performed on the paranasal sinuses. Over 30 million Americans are affected by rhinosinusitis annually, with 73 million days of restricted activity or lost work per year. […] Acute sinusitis is now the fifth leading indication for antimicrobial prescriptions by primary care physicians. […] In March 2012 the Infectious Diseases Society of America (IDSA) published its first clinical practice guidelines on the treatment of acute bacterial sinusitis. […] Each year, 1 in 7 noninstitutionalized Americans over the age of 18 years is diagnosed with acute rhinosinusitis. Despite the fact that 70% of patients improve without antibiotics, rhinosinusitis is still the fifth leading indication for practitioners to prescribe antimicrobials.
#40 Acute sinusitis
https://pmc.ncbi.nlm.nih.gov/articles/PMC3093592/
It has been found that 75% or more of patients with sinusitis in the placebo groups of antibiotic trials get better spontaneously within 7 to 10 days. Complications from acute bacterial sinusitis are very rare; none occurred in the placebo arms of the primary care antibiotic trials. […] In Europe and North America, more than 90% of patients with diagnoses of acute sinusitis in primary care receive prescriptions for antibiotics. This occurs despite the self-limiting natural history of untreated sinus infections and the results of the many antibiotic trials, which show that most patients in the placebo groups get better almost as quickly as those who receive antibiotic treatment. […] A Cochrane systematic review found that, for acute upper respiratory tract infections, use of delayed prescriptions did not result in patient harm and it reduced antibiotic use. One of the trials reviewed was for acute sinusitis; delaying the antibiotic prescription made no difference to outcomes.
#41 Appropriateness of antibiotic prescriptions for acute sinusitis and pharyngitis in an integrated healthcare system | Infection Control & Hospital Epidemiology | Cambridge Core
https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/appropriateness-of-antibiotic-prescriptions-for-acute-sinusitis-and-pharyngitis-in-an-integrated-healthcare-system/F155FD222BA8CAE425EF6D38E2FC9C16
We evaluated the appropriateness of antibiotic prescriptions for acute sinusitis and pharyngitis. Overall, 81% of antibiotic prescriptions for acute sinusitis were inappropriate and 48% of antibiotic prescriptions for pharyngitis were inappropriate. Types of prescribing errors differed between the 2 infections, including lack of an indication for antibiotics and excessive duration in ~50% of sinusitis cases and incorrect antibiotic dose in ~33% of pharyngitis cases.
#42 Acute sinusitis
https://pmc.ncbi.nlm.nih.gov/articles/PMC3093592/
It has been found that 75% or more of patients with sinusitis in the placebo groups of antibiotic trials get better spontaneously within 7 to 10 days. Complications from acute bacterial sinusitis are very rare; none occurred in the placebo arms of the primary care antibiotic trials. […] In Europe and North America, more than 90% of patients with diagnoses of acute sinusitis in primary care receive prescriptions for antibiotics. This occurs despite the self-limiting natural history of untreated sinus infections and the results of the many antibiotic trials, which show that most patients in the placebo groups get better almost as quickly as those who receive antibiotic treatment. […] A Cochrane systematic review found that, for acute upper respiratory tract infections, use of delayed prescriptions did not result in patient harm and it reduced antibiotic use. One of the trials reviewed was for acute sinusitis; delaying the antibiotic prescription made no difference to outcomes.
#43 New rapid diagnostic criteria of acute sinusitis based…
https://otorhinolaryngologypl.com/seo/article/01.3001.0011.6821/en
Unilateral, dull aching headache and facial pain, of changing intensity, lasting all day on an average of 4 to 6 hours with a previous short history of common cold in acute sinusitis is the most common pattern observed in this study. […] Unilateral, dull aching headache and facial pain, of variable intensity, lasting all day on an average of 4 to 6 hours along with is highly sensitive criterion (91%) for diagnosis of acute sinusitis. […] This, along with a history of previous Upper Respiratory tract infection, is useful to rapidly screen patients for acute sinusitis (95% sensitive). […] Acute sinusitis is untreated can lead to a variety of Complications and needs a longer course of Antibiotics for resolution. […] The most common type of pain was unilateral in most of the patients which is strongly suggestive of Acute Sinusitis.
#44 Medical Treatment for Acute Sinusitis: Practice Essentials, Pathophysiology, Epidemiology
https://emedicine.medscape.com/article/861646-overview
About 1 out of every 8 adults in the United States is affected by sinusitis, either acute or chronic. […] Acute sinusitis in the intensive care population is a distinct entity, occurring in 18-32% of patients with prolonged periods of intubation, and is usually diagnosed during the evaluation of unexplained fever.
#45
https://www.atsu.edu/faculty/chamberlain/website/lectures/lecture/urisin.htm
Acute rhinosinusitis occurs in about 32 million people each year in the US. […] In approximately 2% of adults and 10% of children, acute bacterial rhinosinusitis can follow acute viral rhinosinusitis, allergic rhinitis, or other upper respiratory tract infections. […] Patients with hospital-acquired infections are more likely to be infected with gram-negative organisms when they develop acute bacterial rhinosinusitis. […] Rhinocerebral mucormycosis occurs in immunocompromised patients that include diabetic patients with ketoacidosis, transplant recipients, patients with hematologic malignancies, and patients on chronic glucocorticoid or deferoxamine therapy. […] Mortality rates are from 30-70%. The mortality rate in diabetic patients appears to be lower than in nondiabetic patients and in patients with intracerebral involvement. […] Survival rates are highest when the interval from diagnosis to treatment is less than 6 days.
#46 Decreased Antibiotic Use for Acute Otitis Media and Acute Sinusitis Following Implementation of Childhood PCV13 Immunizationlogo-32logo-40logo-60NEJM Journal WatchnejmJW_1L_RGB-b
https://www.jwatch.org/na53714/2021/06/21/decreased-antibiotic-use-acute-otitis-media-and-acute
By reducing the incidence of AOM and AS, 13-valent pneumococcal vaccine reduced the number of associated antibiotic prescriptions. […] Acute otitis media (AOM) and acute sinusitis (AS) are significant reasons for outpatient visits and antibiotic prescriptions. Previous studies have demonstrated reduced rates of AOM and AS after introduction of the 13-valent pneumococcal vaccine (PCV13), but the impact on antibiotic use and prescriptions is of great interest. […] Throughout the study period (2000â2018), the overall incidence of AOM in all age groups fell by 50% (from 62 to 31 per 1000 persons), and AS incidence declined by 18% (from 33 to 27 per 1000), with decreases seen in all age groups except those older than 65. […] In association with the post-PCV period, occurrence of AOM and AS both decreased (incidence rate ratios [IRR], 0.70 and 0.88, respectively).
#47 Decreased Antibiotic Use for Acute Otitis Media and Acute Sinusitis Following Implementation of Childhood PCV13 Immunizationlogo-32logo-40logo-60NEJM Journal WatchnejmJW_1L_RGB-b
https://www.jwatch.org/na53714/2021/06/21/decreased-antibiotic-use-acute-otitis-media-and-acute
By reducing the incidence of AOM and AS, 13-valent pneumococcal vaccine reduced the number of associated antibiotic prescriptions. […] Acute otitis media (AOM) and acute sinusitis (AS) are significant reasons for outpatient visits and antibiotic prescriptions. Previous studies have demonstrated reduced rates of AOM and AS after introduction of the 13-valent pneumococcal vaccine (PCV13), but the impact on antibiotic use and prescriptions is of great interest. […] Throughout the study period (2000â2018), the overall incidence of AOM in all age groups fell by 50% (from 62 to 31 per 1000 persons), and AS incidence declined by 18% (from 33 to 27 per 1000), with decreases seen in all age groups except those older than 65. […] In association with the post-PCV period, occurrence of AOM and AS both decreased (incidence rate ratios [IRR], 0.70 and 0.88, respectively).
#48 Decreased Antibiotic Use for Acute Otitis Media and Acute Sinusitis Following Implementation of Childhood PCV13 Immunizationlogo-32logo-40logo-60NEJM Journal WatchnejmJW_1L_RGB-b
https://www.jwatch.org/na53714/2021/06/21/decreased-antibiotic-use-acute-otitis-media-and-acute
In general, antibiotic utilization decreased during the post-PCV13 period (IRR, 0.65). […] While confirming prior studies showing PCV13 lowers incidence of AOM and AS, this study also highlights a frequently unappreciated collateral benefit of vaccination: fewer antibiotic prescriptions for these infections.
#49 UGA study finds limited evidence to diagnose bacterial sinusitis – College of Public Health UGA
https://publichealth.uga.edu/uga-study-finds-limited-evidence-to-diagnose-bacterial-sinusitis/
UGA study finds limited evidence to diagnose bacterial sinusitis. Sinus infections remain a leading reason why patients are prescribed antibiotics they donât need. But that may be because there isnât a lot of guidance for clinicians on which signs and symptoms accurately point to a bacterial sinus infection. Thatâs according to a new study from the University of Georgia, which analyzed the existing medical literature on diagnosing sinus infection. âThe data on how to clinically diagnose sinusitis is not great,â said Dr. Mark Ebell, epidemiology and biostatistics professor at UGAâs College of Public Health and study lead author. âWe found that there just wasnât a whole lot of data out there for individual signs and symptoms. There were some clinical prediction rules that combine signs and symptom to improve diagnosis, but none of them had been prospectively evaluated, where you develop the rule in one group of patients and then validate it in another group of patients.â
#50 UGA study finds limited evidence to diagnose bacterial sinusitis – College of Public Health UGA
https://publichealth.uga.edu/uga-study-finds-limited-evidence-to-diagnose-bacterial-sinusitis/
UGA study finds limited evidence to diagnose bacterial sinusitis. Sinus infections remain a leading reason why patients are prescribed antibiotics they donât need. But that may be because there isnât a lot of guidance for clinicians on which signs and symptoms accurately point to a bacterial sinus infection. Thatâs according to a new study from the University of Georgia, which analyzed the existing medical literature on diagnosing sinus infection. âThe data on how to clinically diagnose sinusitis is not great,â said Dr. Mark Ebell, epidemiology and biostatistics professor at UGAâs College of Public Health and study lead author. âWe found that there just wasnât a whole lot of data out there for individual signs and symptoms. There were some clinical prediction rules that combine signs and symptom to improve diagnosis, but none of them had been prospectively evaluated, where you develop the rule in one group of patients and then validate it in another group of patients.â
#51 UGA study finds limited evidence to diagnose bacterial sinusitis – College of Public Health UGA
https://publichealth.uga.edu/uga-study-finds-limited-evidence-to-diagnose-bacterial-sinusitis/
Only one in three sinus infections are caused by bacteria, but almost three in four patients are prescribed antibiotics to treat their illness, said Ebell, and in an age of growing antibiotic resistance, this discrepancy between prescription and need is a problem. […] In the study appearing in the Annals of Family Medicine, Ebell and his co-authors sought to identify whether certain symptoms, such as cough, headache, or discolored mucus, best predicted the presence of a bacterial sinus infection. […] They found that the clinicianâs overall impression of the patientâs symptoms, which relies on the doctorâs experience and judgment, was the most accurate method of diagnosis. A patient complaint of a foul odor and pain in the upper teeth were the second and third, respectively, most accurate symptoms of sinus infection.
#52 UGA study finds limited evidence to diagnose bacterial sinusitis – College of Public Health UGA
https://publichealth.uga.edu/uga-study-finds-limited-evidence-to-diagnose-bacterial-sinusitis/
Only one in three sinus infections are caused by bacteria, but almost three in four patients are prescribed antibiotics to treat their illness, said Ebell, and in an age of growing antibiotic resistance, this discrepancy between prescription and need is a problem. […] In the study appearing in the Annals of Family Medicine, Ebell and his co-authors sought to identify whether certain symptoms, such as cough, headache, or discolored mucus, best predicted the presence of a bacterial sinus infection. […] They found that the clinicianâs overall impression of the patientâs symptoms, which relies on the doctorâs experience and judgment, was the most accurate method of diagnosis. A patient complaint of a foul odor and pain in the upper teeth were the second and third, respectively, most accurate symptoms of sinus infection.