Treatment of Sinusitis with Corticosteroids in Combination with Antibiotics in Experimentally Induced Rhinosinusitis

Abstract

Objectives: The objective of this study was to investigate the effects of corticosteroids, antibiotics, and their combination in the therapy of experimental bacterial rhinosinusitis. Methods: Twenty-eight rabbits underwent experimental induction of bacterial rhinosinusitis with Staphylococcus aureus. The animals were assigned randomly to 1 of 4 treatments (saline solution, methylprednisolone, cefazolin sodium, methylprednisolone–cefazolin sodium) for 7 days. After the treatment period, sinus mucosa samples of the animals were examined stereologically. In addition, mucosa samples were used in the determination of myeloperoxidase (MPO) activity. Results: Methylprednisolone, cefazolin, and methylprednisolone-cefazolin had a positive effect on the reduction of neutrophil infiltration to the sinus mucosa in experimental bacterial rhinosinusitis as compared to the group treated with saline solution. However, the effects of methylprednisolone, cefazolin, and methylprednisolone-cefazolin did not significantly differ (p > .05). Similarly, the use of methylprednisolone, cefazolin, and methylprednisolone-cefazolin decreased MPO activity as compared to the group with saline solution (p < .05), and the difference among methylprednisolone, cefazolin, and methylprednisolone-cefazolin was statistically significant (p < .05). The most significant decrease in MPO (neutrophil marker enzyme) activity was determined in the animals treated with methylprednisolone-cefazolin (p < .05). Conclusions: Administering corticosteroids as an adjunct to antibiotics may accelerate the healing process in experimentally induced rhinosinusitis. In this model of rhinosinusitis, an MPO assay was supportive of this hypothesis, although stereological examination showed no statistically significant difference.