Alteration in Bacterial Culture After Treatment With Topical @entity23782 for Recalcitrant XXXX .

@entity1 @entity23782 @entity1200 @entity102
Importance: Topical @entity23782 therapy is used to treat symptomatic @entity102 ( @entity102 ). However, the potential adverse impact of this therapy on the sinus microbiota has not been well quantified. Objective: To determine changes in microbiologic culture results before and after topical @entity23782 therapy in @entity1 with @entity102 with medically and surgically refractory disease. Design, Setting, and @entity1 : We performed a retrospective medical chart review for 22 consecutive adults evaluated and treated between January 1, 2012, and January 1, 2014, at an otolaryngology-rhinology clinic at a regional academic medical center. The @entity1 were 14 @entity1 and 8 @entity1 , who had undergone functional endoscopic sinus surgery for @entity102 , and in whom sinus aspirate cultures were performed before and after topical @entity23782 therapy for symptomatic disease. Analyses were performed in April 2014. Exposures: @entity1 underwent treatment with saline sinus rinse, with the addition of @entity23782 , for at least 1 week. Main Outcomes and Measures: Bacterial isolates from sinus aspirate culture. Results: The @entity1 included 14 @entity1 and 8 @entity1 , 18 to 75 years old, who underwent a mean of 1.9 functional endoscopic sinus surgical procedures. The mean (range) duration of @entity23782 therapy was 6 (2-12) weeks. Before @entity23782 therapy, cultures from symptomatic @entity1 (14 @entity1 and 8 @entity1 , ages 18-75 years) revealed common bacteria implicated in @entity102 , which are characteristically gram-positive. After @entity23782 therapy, cultures from symptomatic @entity1 shifted significantly: 19 were gram-positive vs 3 gram-negative before treatment; 9 were gram-positive vs 13 gram-negative after treatment (P   =   .004), with increased growth of pathogenic gram-negative bacteria and Corynebacterium. Conclusions and Relevance: These data present evidence supporting the distinct abrogation of culturable sinus bacteria after @entity23782 rinses, identifying a shift toward increased pathogenic bacteria. Consideration of healthy host microbiome and @entity1200 should guide future treatment considerations.
