내성비내시경수술의 적응이 되는 만성 부비동염에 대한 세균학적 동정

Abstract

Background and Objectives：Identification of causative organisms in the treatment of chronic rhinosinusitis (CRS) may be a critical step for a successful treatment. There is a consensus on preoperative antibiotics-presc-ription in expert-opinion guidelines, but no on postoperative. The aims of the study were to identify causative bac-terial organisms in the patients who had endoscopic sinus surgery (ESS) for CRS, and to propose a clue for appropriate postoperative antibiotics. Materials and Methods：Thirty-one patients who had at least 2-week antibiotics before taking CT and ESS were included. The exclusion criteria were, under age of 18, having DM, fungal or unilateral sinusitis. Before ESS, antral puncture was taken for sampling the secretion in the maxillary sinus, and then aerobic and anaerobic culture and antibiotic sensitivity test were performed. Results：Two cases of H. influenzae, 4 cases of E. aerogenes, 1 case of M. morganii and 2 cases of S. epidermidis were isolated. Anaerobic bacteria were not identified. The contamination rate was 5.55% and aerobic bacterial identification rate was 19.44%. All bacteria were sensitive to quinolone. Conclusions：Most of the patients, who had ESS for CRS after adequate preoperative antibiotics by guidelines, may have sterile sinuses at the time of sugery. Therefore,a prophylactic short-term antibiotics may be approprated instead of the empirical long-term antibiotics after sinus surgery. (J Clinical Otolaryngol 2010;21:221-225)