{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T19:26:01Z","timestamp":1780860361200,"version":"3.54.1"},"reference-count":23,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2018,5,21]],"date-time":"2018-05-21T00:00:00Z","timestamp":1526860800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Acute exacerbations in patients with chronic rhinosinusitis (CRS) are often treated with courses of systemic antibiotics. Poor correlation between microbiologic culture results and the sinus microbiome in CRS has caused increased debate as to the relevance of culture\u2010directed antibiotics. There is currently sparse data comparing outcomes of culture\u2010directed antibiotics vs non\u2010culture\u2010directed antibiotics for treatment of CRS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This work reports a retrospective review. A total of 946 CRS patients treated with antibiotics were examined; 122 CRS patients with acute exacerbations were treated with culture\u2010directed (n = 61) vs empiric (n = 61) antibiotics. Lund\u2010Kennedy (LK) and 22\u2010item Sino\u2010Nasal Outcome Test (SNOT\u201022) scores were compared pretreatment and posttreatment, with short\u2010term (&lt;1 month) and long\u2010term (1\u20106 months) follow\u2010up. Patient demographics, comorbidities, and prior surgical history were collected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Both groups had similar pretreatment SNOT\u201022 scores (<jats:italic>p<\/jats:italic> = 0.25) while the culture group had higher baseline LK endoscopy scores (<jats:italic>p<\/jats:italic> &lt; 0.01). All data were adjusted for pertinent comorbidities, surgical history, co\u2010therapeutics, and baseline scores. There was no difference in improvement in culture\u2010directed and empirically treated groups in the short\u2010term (<jats:italic>p<\/jats:italic> = 0.77) and long\u2010term (<jats:italic>p<\/jats:italic> = 0.58) for minimal clinically important difference (MCID) of SNOT\u201022 and no difference in the short\u2010term for LK scores (<jats:italic>p<\/jats:italic> = 0.11), but there was significantly more improvement in long\u2010term LK scores in the culture\u2010directed group (<jats:italic>p<\/jats:italic> = 0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Culture\u2010directed therapy improves long\u2010term endoscopy scores but does not yield an advantage in improving short\u2010term endoscopy scores, nor in improving short\u2010term and long\u2010term quality of life scores in CRS patients. A prospective study is necessary to examine the relevance of routine microbiologic cultures in CRS patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.22147","type":"journal-article","created":{"date-parts":[[2018,5,21]],"date-time":"2018-05-21T13:15:37Z","timestamp":1526908537000},"page":"1028-1033","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Comparison of outcomes following culture\u2010directed vs non\u2013culture\u2010directed antibiotics in treatment of acute exacerbations of chronic rhinosinusitis"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1934-4922","authenticated-orcid":false,"given":"Carol H.","family":"Yan","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Stanford University  Stanford CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Navarat","family":"Tangbumrungtham","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Stanford University  Stanford CA"},{"name":"Department of Otorhinolaryngology Ramathibodi Hospital  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ximena A.","family":"Maul","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Stanford University  Stanford CA"},{"name":"Department of Otolaryngology Pontificia Universidad Cat\u00f3lica de Chile  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifei","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Stanford University  Stanford CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayakar V.","family":"Nayak","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Stanford University  Stanford CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter H.","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Stanford University  Stanford CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2072-982X","authenticated-orcid":false,"given":"Zara M.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Stanford University  Stanford CA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,5,21]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"Centers for Disease Control and Prevention (CDC). National Center for Health Statistics. National Health Interview Survey (NHIS).Summary Health Statistics: National Health Interview Survey 2015. Table A\u20102. Selected respiratory diseases among adults aged 18 and over by selected characteristics: United States. Atlanta GA: CDC;2016.https:\/\/ftp.cdc.gov\/pub\/Health_statistics\/NCHs\/NHIS\/SHS\/2015_SHS_Table_A-2.pdf"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-13-210"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2013.07.009"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.4193\/Rhino12.000"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000230402.66579.07"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21846"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2015.04.009"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21277"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.20071"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21195"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21591"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00060-16"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature17645"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21428"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22068"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21695_c"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-4486.2009.01995.x"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwq433"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-016-2640-x"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1179\/joc.2002.14.5.508"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599815572097"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis370"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anaerobe.2005.08.002"}],"container-title":["International Forum of Allergy &amp; Rhinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Falr.22147","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/alr.22147","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,17]],"date-time":"2023-09-17T21:38:05Z","timestamp":1694986685000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/alr.22147"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,5,21]]},"references-count":23,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2018,9]]}},"alternative-id":["10.1002\/alr.22147"],"URL":"https:\/\/doi.org\/10.1002\/alr.22147","archive":["Portico"],"relation":{},"ISSN":["2042-6976","2042-6984"],"issn-type":[{"value":"2042-6976","type":"print"},{"value":"2042-6984","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,5,21]]},"assertion":[{"value":"2018-03-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-05-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-05-21","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}