Title: Acute sinusitis - Treatment and management with mucolytic agents
Thorsten Zehlicke received his Medical degree from Hamburg University, School of Medicine in l998, followed by residency training in ENT at Armed Forces Hospital Hamburg. He served in the Bundeswehr medical service from 1994 till now, attaining a rank of commander. He served on the Faculty of Rostock University School of Medicine as Assistant Professor (2004-2009). In 2014 he became Professor at the Fresenenius Business School in Hamburg, teaching students in health economics. His research and clinical interests include the function of the Eustachian tube, auditory implants and the treatment of the paranasal sinuses. Since 2009 he is chair of the hearing center, Armed Forces Hospital Hamburg.
The most common etiology of acute rhinosinusitis is a viral infection associated with the common cold. Viral rhinosinusitis is complicated by acute bacterial infection in only 0.5 to 2.0 percent of episodes. The primary goals of management of acute sinusitis are to eradicate the infection, decrease the severity and duration of symptoms, and prevent complications. These goals are achieved through the provision of adequate drainage and appropriate systemic treatment of the likely bacterial pathogens. Several studies and meta-analyses have addressed the efficacy of systemic antibiotics in the treatment of acute rhinosinusitis. Given the difficulty in distinguishing viral from bacterial infection, these studies are complicated by heterogeneity in patient symptoms, underlying etiology, and outcomes of treatment. So the value of antibiotics in the treatment of acute rhinosinusitis is not clear. Mucolytic agents (eg, GeloMyrtol) have the benefit of thinning mucous secretions and improving drainage. They are not, however, commonly used in clinical practice in the treatment of acute sinusitis. We present our differentiated therapy of acute rhinosinusitis which depends on mucolytic agents, topical glucocorticoids and topical decongestants that corresponds to patient needs and avoids antibiotic administration.
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