Role of topical antibacterial therapy in patients with cystic fibrosis

Svistushkin V.M.; Sinkov E.V.; Nikiforova G.N.

doi:https://doi.org/10.17116/otorino20218604159

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RESEARCH OBJECTIVES

Assess the efficacy of topical antibacterial therapy in adult cystic fibrosis patients after surgery on nasal cavity structures and paranasal sinuses.

MATERIAL AND METHODS

In the clinic for ear, nose and throat diseases at Sechenov University, 46 adult patients with cystic fibrosis and chronic rhinosinusitis were observed; all patients underwent extended endoscopic polysinusotomy. According to clinical studies, Isofra nasal spray is highly effective and safe in the treatment of patients with infectious diseases of the nasal cavity, nasopharynx and paranasal sinuses.

FINDINGS

The use of Isofra nasal spray (the active ingredient is framycetin sulfate) in our clinic in patients with cystic fibrosis against the background of basic therapy (inhalation with bronchodilators and mucolytics, intranasal topical steroids), had a positive effect on the microbial landscape in the nasal cavity in patients with cystic fibrosis in the postoperative period and allowed to reduce the need for the appointment of systemic antibacterial drugs.

Keywords:

cystic fibrosis

chronic rhinosinusitis

extended endoscopic polysinusotomy

topical antibiotic therapy

framycetin sulfate

Isofra

Authors:

Svistushkin V.M.

Sechenov First Moscow State Medical University

ORCID: 0000-0002-1257-9879

Sinkov E.V.

Sechenov First Moscow State Medical University

ORCID: 0000-0003-4870-5977

Nikiforova G.N.

Sechenov First Moscow State Medical University

SPIN RSCI: 8740-0690
ORCID: 0000-0002-8617-0179

Received:

02.06.2021

Accepted:

08.07.2021

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References:

Cystic Fibrosis Foundation. Patient Registry 2015. Annual Data Report Bethesda, Maryland 2016 Cystic Fibrosis Foundation. Accessed May 25, 2021. https://www.cff.org/Our-Research/CF-Patient-Registry/2015-Patient-Registry-Annual-Data-Report.pdf
Kapranov NI, Kashirskaya NYu. Mukoviscidoz. Monografiya. M.: Medpraktika; 2014. (In Russ.).
Kondrat’eva EI, Kashirskaya NYu, Kapranov NI. Mukoviscidoz: opredelenie, diagnosticheskie kriterii, terapiya. Nacional’nyj konsensus. M.: OOO «Kompaniya BORGES; 2016. (In Russ.).
Rommens JM, Iannuzzi MC, Kerem B, Drumm ML, Melmer G, Dean M, Rozmahel R, Cole JL, Kennedy D, Hidaka N, et al. Identification of the cystic fibrosis gene: chromosome walking and jumping. Science. 1989;245(4922):1059-1065. https://doi.org/10.1126/science.2772657
Voronkova AYu, Amelina EL, Kashirskaya NYu, Kondrat’eva EI, Krasovskij SA, Starinova MA, Kapranov NI. Registr bol’nyh mukoviscidozom v Rossijskoj Federacii. M.: ID «MEDPRAKTIKA-M»; 2019. (In Russ.).
Mogayzel PJ Jr, Naureckas ET, Robinson KA, Mueller G, Hadjiliadis D, Hoag JB, Lubsch L, Hazle L, Sabadosa K, Marshall B; Pulmonary Clinical Practice Guidelines Committee. Cystic Fibrosis Pulmonary Guidelines. American Journal of Respiratory and Critical Care Medicine. 2013;187(7):680-689. https://doi.org/10.1164/rccm.201207-1160oe
Teem J, Berger H, Ostedgaard L, Rich D, Tsui L, Welsh M. Identification of revertants for the cystic fibrosis ΔF508 mutation using STE6-CFTR chimeras in yeast. Cell. 1993;73(2):335-346. https://doi.org/10.1016/0092-8674(93)90233-g
Sherman VD, Kondrat’eva EI, Voronkova AYu, Kashirskaya NYu, Shabalova LA, Nikonova VS, Zhekajte EK, Kucev SI. The influence of neonatal screening on the course of cystic fibrosis on the example of a group of patients in the Moscow region. Medicinskij Sovet. 2017;18:124-128. (In Russ.). https://doi.org/10.21518/2079-701X-2017-18-124-128
Orlov AV, Simonova OI, Roslavceva EA, Shadrin DI. Mukoviscidoz (klinicheskaya kartina, diagnostika, lechenie, reabilitaciya, dispanserizaciya). Uchebnoe posobie dlya vrachej. SPb.: SZGMU im. I.I. Mechnikova; 2014. (In Russ.).
Liu JC, Modha DE, Gaillard EA. What is the clinical significance of filamentous fungi positive sputum cultures in patients with cystic fibrosis? Journal of Cystic Fibrosis. 2013;12(3):187-193. https://doi.org/10.1016/j.jcf.2013.02.003
McKinzie, Chen L, Ehlert K, Grisso A, Linafelter A, Lubsch L, O’Brien C, Pan A, Wright A, Elson E. Off-label use of intravenous antimicrobials for inhalation in patients with cystic fibrosis. Pediatric Pulmonology. 2019;54(3):27-45. https://doi.org/10.1002/ppul.24511
Gysin C, Alothman G.A, Papsin BC. Sinonasal disease in cystic fibrosis: Clinical characteristics, diagnosis, and management. Pediatric Pulmonology. 2000;30(6):481-489. https://doi.org/10.1002/1099-0496(200012)30:6%3C481::aid-ppul8%3E3.0.co;2-n
Krzeski A, Kapiszewska-Dzedzej D, Górski N, Jakubczyk I, Cimmino M, Cavaliere M. Cystic Fibrosis in Rhinologic Practice. American Journal of Rhinology. 2002;16(3):155-160. https://doi.org/10.1177/194589240201600306
Cimmino M, Cavaliere M, Nardone M, Plantulli A, Orefice A, Esposito V, Raia V. Clinical characteristics and genotype analysis of patients with cystic fibrosis and nasal polyposis1. Clinical Otolaryngology and Allied Sciences. 2003;28(2):125-132. https://doi.org/10.1046/j.1365-2273.2003.00677.x
Henriksson G, Westrin K, Karpati F, Wikstroïm A, Stierna P, HjelteHodson L. Nasal Polyps in Cystic Fibrosis. Chest. 2002;121(1):40-47. https://doi.org/10.1378/chest.121.1.40
Beirne P, Banner N, Khaghani A, Hodson M, Yacoub M. Lung Transplantation for Non-Cystic Fibrosis Bronchiectasis: Analysis of a 13-Year Experience. The Journal of Heart and Lung Transplantation. 2005;24(10):153-155. https://doi.org/10.1016/j.healun.2004.12.114
Babinski D, Trawinska-Bartnicka M. Rhinosinusitis in cystic fibrosis: Not a simple story. International Journal of Pediatric Otorhinolaryngology. 2008;72(5):619-624. https://doi.org/10.1016/j.ijporl.2008.01.010
Albritton F, Kingdom T. Endoscopic Sinus Surgery in Patients with Cystic Fibrosis: An Analysis of Complications. American Journal of Rhinology. 2000;14(6):379-385. https://doi.org/10.2500/105065800779954338
Berkhout M, Rijntjes E, Bouazzaoui L, Fokkens W, Brimicombe R, Heijerman H. Importance of bacteriology in upper airways of patients with Cystic Fibrosis. Journal of Cystic Fibrosis. 2013;12(5):525-529. https://doi.org/10.1016/j.jcf.2013.01.002
Berkhout M, Rooden C, Rijntjes E, Fokkens W, Bouazzaoui L, Heijerman H. Sinonasal manifestations of cystic fibrosis: A correlation between genotype and phenotype? Journal of Cystic Fibrosis. 2014;13(4):442-448. https://doi.org/10.1016/j.jcf.2013.10.011
Hamilos DL. Nasal and sinus problems in cystic fibrosis patients. In: Bachert C, Bourdin A, Chanez P, eds. The Nose and Sinuses in Respiratory Disorders (ERS Monograph). Sheffield, European Respiratory Society; 2017. https://doi.org/10.1183/2312508x.10009616
Woodworth B, Ahn C, Flume P, Schlosser R. The Delta F508 Mutation in Cystic Fibrosis and Impact on Sinus Development. American Journal of Rhinology. 2007;21(1):122-127. https://doi.org/10.2500/ajr.2007.21.2905
April M, Tunkel D, DeCelie-Germana J, Zeitlin P, Zinreich S. Computed Tomography (CT) Scan Findings of the Paranasal Sinuses in Cystic Fibrosis. American Journal of Rhinology. 1995;9(5):277-280. https://doi.org/10.2500/105065895781808892
Godoy J, Godoy A, Ribalta G, Largo I. Bacterial Pattern in Chronic Sinusitis and Cystic Fibrosis. Otolaryngology — Head and Neck Surgery. 2011;145(4):673-676. https://doi.org/10.1177/0194599811407279
Boutin S, Graeber S, Stahl M, Dittrich A, Mall M, Dalpke A. Chronic but not intermittent infection with Pseudomonas aeruginosais associated with global changes of the lung microbiome in cystic fibrosis. European Respiratory Journal. 2017;50(4):1701086. https://doi.org/10.1183/13993003.01086-2017
Rudkjøbing V, Aanaes K, Wolff T, Buchwald C, Johansen H, Thomsen T. An exploratory study of microbial diversity in sinus infections of cystic fibrosis patients by molecular methods. Journal of Cystic Fibrosis. 2014;13(6):645-652. https://doi.org/10.1016/j.jcf.2014.02.008
Lavin J, Bhushan B, Schroeder J. Correlation between respiratory cultures and sinus cultures in children with cystic fibrosis. International Journal of Pediatric Otorhinolaryngology. 2013;77(5):686-689. https://doi.org/10.1016/j.ijporl.2013.01.018
Sobin L, Kawai K, Irace K, Gergin O, Cunningham M, Sawicki G, Adil E. Microbiology of the Upper and Lower Airways in Pediatric Cystic Fibrosis Patients. Otolaryngology — Head and Neck Surgery. 2017;157(2):302-308. https://doi.org/10.1177/0194599817702332
Muhlebach M, Miller M, Moore C, Wedd J, Drake A, Leigh M. Are lower airway or throat cultures predictive of sinus bacteriology in cystic fibrosis? Pediatric Pulmonology. 2006;41(5):445-451. https://doi.org/10.1002/ppul.20396
Franche G, Silva F, Saleh C. Bacteriology of the Middle Meatus Aspirate in Patients with Cystic Fibrosis. Brazilian Journal of Otorhinolaryngology. 2007;73(4):494-499. https://doi.org/10.1016/s1808-8694(15)30100-2
El’kov IV, Habarov AA. The study of the penetration of morphocycline into the blood and mucosa of the maxillary sinus. Zhurnal ushnyh, nosovyh i gorlovyh boleznej. 1991;3:9-11. (In Russ.).
Rezoljucija soveta jekspertov NMAO po probleme antibiotikoterapii v otorinolaringologii. Rossijskaja otorinolaringologija. 2019;18(1)(98):135-138. (In Russ.).
Fokkens WJ, Lund VJ, Hopkins C, Hellings PW, Kern R, Reitsma S, Toppila-Salmi S, Bernal-Sprekelsen M, Mullol J, Alobid I, Terezinha Anselmo-Lima W, Bachert C, Baroody F, von Buchwald C, Cervin A, Cohen N, Constantinidis J, De Gabory L, Desrosiers M, Diamant Z, Douglas RG, Gevaert PH, Hafner A, Harvey RJ, Joos GF, Kalogjera L, Knill A, Kocks JH, Landis BN, Limpens J, Lebeer S, Lourenco O, Meco C, Matricardi PM, O’Mahony L, Philpott CM, Ryan D, Schlosser R, Senior B, Smith TL, Teeling T, Tomazic PV, Wang DY, Wang D, Zhang L, Agius AM, Ahlstrom-Emanuelsson C, Alabri R, Albu S, Alhabash S, Aleksic A, Aloulah M, Al-Qudah M, Alsaleh S, Baban MA, Baudoin T, Balvers T, Battaglia P, Bedoya JD, Beule A, Bofares KM, Braverman I, Brozek-Madry E, Richard B, Callejas C, Carrie S, Caulley L, Chussi D, de Corso E, Coste A, El Hadi U, Elfarouk A, Eloy PH, Farrokhi S, Felisati G, Ferrari MD, Fishchuk R, Grayson W, Goncalves PM, Grdinic B, Grgic V, Hamizan AW, Heinichen JV, Husain S, Ping TI, Ivaska J, Jakimovska F, Jovancevic L, Kakande E, Kamel R, Karpischenko S, Kariyawasam HH, Kawauchi H, Kjeldsen A, Klimek L, Krzeski A, Kopacheva Barsova G, Kim SW, Lal D, Letort JJ, Lopatin A, Mahdjoubi A, Mesbahi A, Netkovski J, Nyenbue Tshipukane D, Obando-Valverde A, Okano M, Onerci M, Ong YK, Orlandi R, Otori N, Ouennoughy K, Ozkan M, Peric A, Plzak J, Prokopakis E, Prepageran N, Psaltis A, Pugin B, Raftopulos M, Rombaux P, Riechelmann H, Sahtout S, Sarafoleanu CC, Searyoh K, Rhee CS, Shi J, Shkoukani M, Shukuryan AK, Sicak M, Smyth D, Sindvongs K, Soklic Kosak T, Stjarne P, Sutikno B, Steinsvag S, Tantilipikorn P, Thanaviratananich S, Tran T, Urbancic J, Valiulius A, Vasquez de Aparicio C, Vicheva D, Virkkula PM, Vicente G, Voegels R, Wagenmann MM, Wardani RS, Welge-Lussen A, Witterick I, Wright E, Zabolotniy D, Zsolt B, Zwetsloot CP. European Position Paper on Rhinosinusitis and Nasal Polyps. Rhinology. 2020;58(Suppl S29):1-464. https://doi.org/10.4193/Rhin20.600
Goh Y, Goode R. State of the Art Review: Current Status of Topical Nasal Antimicrobial Agents. The Laryngoscope. 2000;110(6):875-880. https://doi.org/10.1097/00005537-200006000-00001
Strachunskij LS. Klinicheskaya mikrobiologiya i antimikrobnaya terapiya. Prakticheskoe rukovodstvo po antiinfekcionnoj himioterapii. Pod red. Strachunskogo L.S., Belousova Yu.B., Kozlova S.N. Smolensk: Mezhregional’naya associaciya obshchestvennyh ob»edinenij «Mezhregional’naya associaciya po klinicheskoj mikrobiologii i antimikrobnoj himioterapii»; 2007. (In Russ.).
Kunel’skaya NL, Turovskij AB. The role of topical antibiotics in the treatment of diseases accompanied by rhinopharyngeal symptoms. Lechebnoe Delo. 2018;1:60-65. (In Russ.). https://doi.org/10.24411/2071-5315-2018-11984
Kokorina VE. Analiz rezul’tatov vozmozhnosti mestnoj terapii ostryh rinosinusitov kak oslozhnenij grippa H1N1 u chasto boleyushchih detej. Materialy VII Peterburgskogo foruma otorinolaringologov Rossii. 2018. (In Russ.).
Bennion B, Be N, McNerney M, Lao V, Carlson E, Valdez C, Malfatti M, Enright H, Nguyen T, Lightstone F, Carpenter T. Predicting a Drug’s Membrane Permeability: A Computational Model Validated With in Vitro Permeability Assay Data. The Journal of Physical Chemistry B. 2017;121(20)5228-5237. https://doi.org/10.1021/acs.jpcb.7b02914
Ryazancev SV. Otofa, isofra and polydex are new drugs for the treatment of otitis and rhinosinusitis. Novosti otorinolaringologii i logopatologii. 1999;2:115-116. (In Russ.).