Oral antibiotics used in the treatment of chronic rhinosinusitis have limited penetration into the sinonasal mucosa: a randomized trial.

Oral antibiotics used in the treatment of chronic rhinosinusitis have limited penetration into the sinonasal mucosa: a randomized trial. Xenobiotica. 2020 Aug 25;:1-25 Authors: Siu J, Klingler L, Wang Y, Hung CT, Jeong SH, Smith S, Tingle M, Wagner Mackenzie B, Biswas K, Douglas R Abstract Despite the widespread prescription of antibiotics for patients with chronic rhinosinusitis (CRS), the extent to which drug distribution to the sinonasal mucosa occurs remains largely undefined.Twenty subjects undergoing functional endoscopic sinus surgery (FESS) for CRS were randomized to one of two groups: 1) doxycycline (100 mg daily for seven days) 2) roxithromycin (300 mg daily for seven days). Drug levels were measured using liquid chromatography-tandem mass spectrometry in sinonasal mucus, sinonasal tissues and serum at steady state.Doxycycline concentrations measured in the mucus were significantly lower compared to that in the serum (mean mucus/serum ratio =0.16, p < 0.001) and the tissue (mean mucus/tissue ratio =0.18, p < 0.0001). Roxithromycin concentrations in the mucus were also significantly lower compared to that in the serum (mean mucus/serum ratio =0.37, p = 0.002) and the tissue (mean mucus/tissue ratio =0.60, p < 0.001).Although the efficacy of doxycycline and roxithromycin in sinonasal mucus in vivo cannot be predicted solely from reported minimum inhibitory concentrations, given the added complexit...
Source: Xenobiotica - Category: Research Authors: Tags: Xenobiotica Source Type: research