Stanford researchers study emerging treatment for chronic sinus infections

December 26, 2002

STANFORD, Calif. Three years ago, Joanne Clark was so miserable from recurring sinus infections and the antibiotics used to treat them that she felt ready to give up. Despite three surgeries, Clark, a resident of Lodi, Calif., continued getting sinus infections every two to four weeks. The painful headaches and feelings of exhaustion, not to mention the severe nausea from oral antibiotics, forced her to quit her job as a physical education teacher. "I felt horrible," she said. "I had headaches all the time. I had no energy. I didn"t want to live a life like this."

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."

While asthma patients have long relied upon nebulizers to inhale medication into their lungs, the use of nebulized antibiotics to treat sinus infections emerged only in the last two to three years.

Why does the treatment work so well? "The common-sense answer is, we're getting more of the medication directly to the tissues that need it" because the medication is inhaled into the nostrils instead of circulating through the entire body, Vaughan said. He added that more research is needed to understand exactly how the treatment works.

Vaughan chairs the scientific advisory board of SinusPharmacy Corp., a company that formulates nebulized antibiotics and other medications to treat sinus infections. The company"s medications were used in the Stanford study. All data from the study were analyzed independently of the company. The research was funded solely by Stanford University Medical Center.

Clark, for her part, still gets sinus infections three to four times a year, but she said the episodes are far more manageable with nebulized antibiotics. Because her health has improved, she has returned to work at the school district.

"I feel great most of the time," Clark said. "I tell people this treatment gave me my life back."
Stanford University Medical Center integrates research, medical education and patient care at its three institutions - Stanford University School of Medicine, Stanford Hospital & Clinics and Lucile Packard Children's Hospital at Stanford. For more information, please visit the Web site of the medical center's Office of Communication & Public Affairs at

Stanford University Medical Center

Related Antibiotics Articles from Brightsurf:

Insights in the search for new antibiotics
A collaborative research team from the University of Oklahoma, the Memorial Sloan Kettering Cancer Center and Merck & Co. published an opinion article in the journal, Nature Chemical Biology, that addresses the gap in the discovery of new antibiotics.

New tricks for old antibiotics
The study published in the journal Immunity reveals that tetracyclines (broad spectre antibiotics), by partially inhibiting cell mitochondria activity, induce a compensatory response on the organism that decreases tissue damage caused during infection.

Benefits, risks seen with antibiotics-first for appendicitis
Antibiotics are a good choice for some patients with appendicitis but not all, according to study results published today in the New England Journal of Medicine.

How antibiotics interact
Understanding bottleneck effects in the translation of bacterial proteins can lead to a more effective combination of antibiotics / study in 'Nature Communications'

Are antivitamins the new antibiotics?
Antibiotics are among the most important discoveries of modern medicine and have saved millions of lives since the discovery of penicillin almost 100 years ago.

Hygiene reduces the need for antibiotics by up to 30%
A new paper published in the American Journal of Infection Control (AJIC), finds improved everyday hygiene practices, such as hand-washing, reduces the risk of common infections by up to 50%, reducing the need for antibiotics, by up to 30%.

Antibiotics: City dwellers and children take the most
City dwellers take more antibiotics than people in rural areas; children and the elderly use them more often than middle-aged people; the use of antibiotics decreases as education increases, but only in rich countries: These are three of the more striking trends identified by researchers of the NRW Forschungskolleg ''One Health and Urban Transformation'' at the University of Bonn.

Metals could be the link to new antibiotics
Compounds containing metals could hold the key to the next generation of antibiotics to combat the growing threat of global antibiotic resistance.

Antibiotics from the sea
The team led by Prof. Christian Jogler of Friedrich Schiller University, Jena, has succeeded in cultivating several dozen marine bacteria in the laboratory -- bacteria that had previously been paid little attention.

Antibiotics not necessary for most toothaches, according to new ADA guideline
The American Dental Association (ADA) announced today a new guideline indicating that in most cases, antibiotics are not recommended for toothaches.

Read More: Antibiotics News and Antibiotics Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to