Stanford Researchers Study Emerging Treatment For Chronic Sinus Infections

Clark eventually came to Stanford Hospital & Clinics where Winston Vaughan, MD, an otolaryngologist, sinus surgeon and director of the Stanford Sinus Center, suggested she participate in a clinical trial of an innovative new treatment. Instead of taking antibiotics in a pill, Clark could breathe them into her sinuses using a nebulizer - a machine that converts medication from a liquid into an inhalable mist.

Conducted over 12 months beginning in November 2000, the study is the first to prospectively evaluate the effectiveness of nebulized antibiotics for the treatment of chronic sinusitis following surgery. Results are published in the December issue of Otolaryngology, Head and Neck Surgery.

After taking the nebulized antibiotics twice daily for three weeks, Clark experienced significant relief. Her symptoms including headaches, congestion and fatigue subsided more quickly than with antibiotic pills, and she remained infection-free far longer - nearly three months. While she experienced some mild side effects, "it was nothing compared with the pills." Most of the other study participants saw similar benefits from nebulized antibiotics. Of the 42 patients studied - all adults who suffered recurrent sinus infections after surgery - 76 percent reported "significant improvement" in symptoms, confirmed through physical exams and sinus endoscopies.

Significantly, the patients who benefited from the treatment remained free of infection for an average of 17 weeks, compared with six weeks previously. Like Clark, they reported few side effects and improved quality of life.

Based on these results, Vaughan believes nebulized antibiotics represent a promising alternative for patients who continue getting sinus infections even after surgery and who have failed, or cannot tolerate, oral or intravenous antibiotics. "These results are very encouraging," said Vaughan, assistant professor of surgery at the School of Medicine and lead author of the study. Nebulized antibiotics "may serve as a new treatment option in an often frustrating disease process."

Sinusitis affects 35 million Americans, making it the country's most prevalent chronic condition, according to the Centers for Disease Control and Prevention. As Clark"s experience shows, the condition can significantly reduce productivity and quality of life.

"These patients feel miserable," Vaughan said. "They have facial pain, they can't breathe and they can't sleep." Nebulized antibiotics, he said, were developed in the late 1990s "out of a desperate need for something else."