الفهرس 
Anatomy of Paranasal SinusesOnly 14 pages are availabe for public view
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Abstract
Background: chronic rhinosinusitis (CRS) is characterized by inflammation of themucosa of the nose and paranasal sinuses. The role of bacterial or fungal infection in CRS is unclear, yet antimicrobials are commonly prescribed for this condition. Published guidelines offer li_le direction regarding antibiotic strategies for CRS.
The purpose of this article is to provide an evidence-based approach to the use of antibacterial
and antifungal antibiotics in the management of CRS.
Methods: A meta-analysis study was performed following recommendations of the Clinical Practice
Guideline Manual, Conference on Guideline Standardization (COGS), and the Appraisal of Guidelines and Research Evaluation (AGREE). Inclusion criteria were: age ≥18 years old, chronic rhinosinusitis without polyps, antibiotic treatment as the experimental group, and clearly defined primary clinical endpoint. Studies involving patients with cystic fibrosis or acute invasive fungal sinusitis were
excluded.
Results: The review identified and evaluated the literature on the following classes of antimicrobials and steroids for CRS: oral antibacterial antibiotics ≤3 weeks, oral antibacterial antibiotics >3 weeks, macrolide antibiotics, intravenous antibacterial antibiotics, topical antibacterial antibiotics, oral antifungals,
intravenous antifungals, and topical antifungals.
Conclusion: Based on the available evidence, oral antibacterial antibiotics and prolonged macrolide antibiotics are considered therapeutic options in the treatment of CRS while the use of topical antibacterial antibiotics and oral, topical, would be recommended against. These evidence-based recommendations should not necessarily be applied to all patients with CRS and are not intended to supersede clinical judgment based on individual patient circumstances.