Principles of antibacterial therapy for infections affecting the upper respiratory tract: A clinical case

Acute bacterial rhinosinusitis is about 0.5–2% of the total number of acute rhinosinusitis. Most often the etiological agents are Streptococcus pneumoniae, Moraxella Catarrhalis and Haemophilus Influenzae. Amoxicillin is most often used as antibacterial therapy of the first line. The growth of S. pneumoniae resistance to penicillins is increasing. Penicillin’s not working. It is necessary to find a viable alternative antibacterial treatment. It should be considered as an initial treatment of the third-generation cephalosporins, in particular Cefixime. A clinical case of patient treatment is presented sought medical care at the clinic of the ear, throat and nose diseases. The patient complained of а purulent nasal discharge, postnasal drip, hyposmia, unpleasant odor from the nose, temperature of 37.6 °C, discomfort in the projection of both maxillary sinuses, swelling in the area of the upper eyelid of the right eye. Аn additional examination was carried out and the diagnosis of “Acute bacterial rhinosinusitis” was established. The patient was on outpatient treatment. The initial antibacterial therapy was the Cefixime in the form of dispersed tablets 400 mg once a day for 7 days. Positive dynamics was already noted on the 3^rd day of treatment, the complete relief of clinical symptoms was achieved by the tenth day. On the NOSE scale, the patient scored 80 points on the day of circulation, on 3 days – 40 points, on the 7^th day – 20 points. The results of a microbiological examination were obtained seven days after the start of treatment. It detected the growth of S. Pneumoniae 10^6 sensitive to all antibacterial drugs. The presented clinical case demonstrates the high response of the outpatient medicine. The Cefixime can be recommended as the drug of choice in causal treatment of the acute bacterial rhinosinusitis, especially in the case of resistance or allergy to penicillin.

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