Local rifampicin in treatment of rhinoscleroma

Abstract

SummaryMany antibiotics, chemotherapeutic agents and other chemicals have been tried in the treatment of scleroma without much success (Toppozada et al, 1967). The most popular of these drugs are streptomycin and aureomycin (Botros et al, 1954; Zwiefach, 1955; El-Mofty, 1962), terramycin and chloromycetin (Hoover and King, 1953) and ampicillin, septrin and vibramycin (Ssali, 1975).El-Mofty and Attia (1957) attributed considerable value to the use of 20 per cent aureomycin ointment locally in treating the disease. Nigonol in the form of a local injection was tried by Toppozada et al. (1967) and they claimed good results. Shaer et al. (1981) reported that local application of 2 per cent acriflavine solution over an eight-week period was an effective and safe remedy for rhinoscleroma.Rifampicin has been used systemically with success as a new antibiotic for the treatment of scleroma (Riad, 1982). The aim of the present study was to evaluate the response of rhinoscleroma to local medication with rifampicin.selected for this study. The cases were diagnosed by clinical, histopathological (Fig. 1) and bacteriological data. Twelve cases were in the atrophic stage while eighteen were in the granulomatous stage of the disease. Rifampicin was applied locally into the nose in two forms:1. Nasal instillations: used mainly in the atrophic cases. One ampoule of rifampicin (Rifocin-Lepetit®) 125 mg. diluted in 20 ml. saline solution was used and 2 ml. of the solution was applied twice daily.2. Nasal infiltration: used mainly in the granulomatous cases. One ampoule of rifampicin (Rifocin-Lepetit®) 125 mg. was infiltrated into the granulomas every other day.Treatment was continued for eight weeks. Punch bio-spies were taken from the nasal lesions after four and eight weeks during the course of therapy and six months after the cessation of treatment. Biopsies were fixed, dehydrated, embedded in paraffin, sectioned and stained with H and E. Part of each specimen was submitted to bacteriological studies for the isolation of K. rhi-noscleromatis (Levine, 1951).