Local treatment of acute rhinosinusitis in the era of COVID-19

Abstract

   Introduction. Acute rhinosinusitis accounts for 40 % to 60 % of the morbidity in the structure of ENT pathology. COVID-19 pathogen, similarly to other respiratory viruses, can cause acute rhinosinusitis, which is the most relevant at the present time due to the ongoing pandemic. Viral etiology accounts for 90–98 % of all cases of acute rhinosinusitis. Accordingly, the choice of treatment tactics with antibacterial drugs in a number of cases is unreasonable and leads to the growth of antibiotic resistance. Local antiseptics containing sodium hypochlorite with a high safety profile that do not cause pathogen resistance are used to increase the effectiveness of therapy for acute rhinosinusitis.   Objective. To evaluate the effectiveness of nasal spray containing sodium hypochlorite on the duration of the course of exacerbation and severity of acute rhinosinusitis during the epidemiological season.   Materials and methods. The study involved 50 patients who were divided into 3 groups: 10 patients (group 1) with acute viral rhinosinusitis (therapy: sodium hypochlorite + decongestants); 20 patients (group 2) with acute bacterial rhinosinusitis (therapy: sodium hypochlorite + systemic antibacterial therapy); 20 patients (group 3) with acute bacterial rhinosinusitis (therapy: nasal lavage with isotonic sea salt solution + systemic antibacterial therapy).   Results and discussion. Pathogen eradication – the absence of the original pathogen at the locus of the inflammatory process during dynamic microbiological examination – was found in 14 (35 %) clinical cases: in Group 2 (sodium hypochlorite) – 10 (25 %) and in Group 3 (nasal irrigation with isotonic sea water solution) – 4 (10 %).   Conclusions. The results of microbiological studies showed effective antimicrobial properties of sodium hypochlorite when applied to the inflamed mucous membranes, expressed in a statistically significant reduction of bacterial semination of the nasal cavity epithelium.