Local antibacterial therapy in patients with diseases of the nasal cavity and paranasal sinuses, including against the background of cystic fibrosis

Abstract

Acute respiratory viral infection is one of the most common infectious diseases. Clinical manifestations vary from time to time and from person to person and, as a rule, include intoxication and catarrhal syndromes. ARVI is more often caused by such causative agents as pneumoviruses, human metapneumovirus, coronaviruses, rhinoviruses, adenoviruses and bocaviruses. Among diseases of the ENT organs, ARVI can cause rhinosinusitis and pharyngitis. The inflammation that occurs in the mucosa causes its dystrophy and necrosis, which leads to the dysfunction of mucociliary clearance. As a result, an optimal environment for the development of bacterial flora is created. Bacterial rhinosinusitis needs antibiotic therapy. These drugs can act locally and systemically. It is well known that topical drugs have fewer side effects and result in a greater active substance concentration directly at a site of inflammation. Currently, a nasal framycetin spray is used as a topical antibacterial therapy to treat bacterial rhinosinusitis and in the early postoperative period. Topical drugs have a good evidence base, fewer side effects, and are safe, even for patients with cystic fibrosis. Given the significant antibiotics load in patients with cystic fibrosis, any opportunity to delay re-administration of antibiotics is a positive thing. In this aspect, topical antibiotics that have no systemic adverse events, including negative effects on the normal human microbiome, and can be used to overcome the resistance of microorganisms in a varying degree due to the achievement of high active substance concentration directly in a focus of infection may have a certain therapeutic value. The article addresses issues of epidemiology, pathogenesis, clinical manifestations of acute respiratory viral infection, i. e. acute rhinosinusitis. In addition, the article describes the use of topical antibiotic therapy for the treatment of diseases of the nasal cavities and paranasal sinuses.