{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T13:52:45Z","timestamp":1767707565939},"reference-count":41,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2014,1,10]],"date-time":"2014-01-10T00:00:00Z","timestamp":1389312000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2014,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Despite their widespread use, antibiotics have not been shown to improve chronic rhinosinusitis (CRS) outcomes. We aimed to determine whether culture\u2010inappropriate postoperative antibiotic therapy was associated with less quality\u2010of\u2010life (QOL) improvement following functional endoscopic sinus surgery (FESS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective cohort study recruited 376 adult CRS patients undergoing FESS between October 1, 2007 to December 31, 2011. Patient demographics, comorbidities and medications were collected at baseline. Trimethoprim\u2010sulfamethoxazole and clindamycin were administered for 2 weeks postoperatively. The antibiotic appropriateness was determined based on bacterial resistance profile of organisms identified during intraoperative culture. The QOL outcome was defined as change of 22\u2010item Sinonasal Outcome Test scores from preoperative visit to 1\u2010month, 3\u2010month, and 6\u2010month post\u2010FESS. Clinically significant difference was defined as at least 0.5 standard deviations (SD) of baseline QOL score in the reference group. Mixed\u2010effects regression models were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seven percent of patients (n = 27) had culture\u2010inappropriate antibiotic therapy, and additional 5% (n = 19) had culture\u2010specific antibiotic adjustment. Compared to patients with culture\u2010appropriate antibiotics, patients with culture\u2010inappropriate antibiotics had significantly less improvement of QOL from baseline to postoperative 1\u2010month and 3\u2010month follow\u2010up where the difference became clinically significant; patients with antibiotic adjustment had more QOL improvement from baseline to 1\u2010month follow\u2010up, but their QOL worsened at 3\u2010month follow\u2010up, and these changes were not clinically significant. However, all effects washed out at 6\u2010month follow\u2010up with no significant differences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Culture\u2010inappropriate postoperative antibiotic therapy decreased short\u2010term QOL improvement to a clinically meaningful level after FESS. Culture guided selection of antibiotics may improve short\u2010term FESS outcome.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.21277","type":"journal-article","created":{"date-parts":[[2014,1,10]],"date-time":"2014-01-10T19:01:53Z","timestamp":1389380513000},"page":"403-410","source":"Crossref","is-referenced-by-count":17,"title":["Culture\u2010inappropriate antibiotic therapy decreases quality of life improvement after sinus surgery"],"prefix":"10.1002","volume":"4","author":[{"given":"Zi","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Biostatistics and Epidemiology Center for Clinical Epidemiology and Biostatistics University of Pennsylvania Perelman School of Medicine  Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James N.","family":"Palmer","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery University of Pennsylvania Perelman School of Medicine  Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Knashawn H.","family":"Morales","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Epidemiology Center for Clinical Epidemiology and Biostatistics University of Pennsylvania Perelman School of Medicine  Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy J.","family":"Howland","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery University of Pennsylvania Perelman School of Medicine  Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurel J.","family":"Doghramji","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery University of Pennsylvania Perelman School of Medicine  Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nithin D.","family":"Adappa","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery University of Pennsylvania Perelman School of Medicine  Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander G.","family":"Chiu","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Arizona  Tucson AZ"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noam A.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery University of Pennsylvania Perelman School of Medicine  Philadelphia PA"},{"name":"Philadelphia Veterans Affairs Medical Center  Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ebbing","family":"Lautenbach","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Epidemiology Center for Clinical Epidemiology and Biostatistics University of Pennsylvania Perelman School of Medicine  Philadelphia PA"},{"name":"Division of Infectious Diseases Department of Medicine University of Pennsylvania Perelman School of Medicine  Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,1,10]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"1","article-title":"Summary health statistics for U.S. children: National Health Interview Survey, 2008","author":"Bloom B","year":"2009","journal-title":"Vital Health Stat 10"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/194589240501900116"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.2500\/105065801781329428"},{"key":"e_1_2_6_5_1","first-page":"1","article-title":"Chronic rhinosinusitis patterns of illness","volume":"20","author":"Hamilos DL","year":"2007","journal-title":"Clin Allergy Immunol"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajr.2007.21.3047"},{"key":"e_1_2_6_7_1","first-page":"97","article-title":"EP3OS 2007: European position paper on rhinosinusitis and nasal polyps 2007. 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