Re: Antibiotic Nasal rinses

[Guest guest]

,

There are pros and cons to the use of antibiotic nasal rinses.

On the pro side, many patients use rinses such as 's solution and report

that their symptoms improve, ie that they have less congestion, etc. This in

itself is a testimony to the fact that those patients have germs inside their

nasal fossa and that these germs are responsible for a good part of their

symptoms.

However, antibiotic rinses are pretty dilute solutions, much more dilute than,

say, a nebulized solution. Therefore, the risk of having germ resistance

emerging over a few months' time is real. Furthermore, being dilute, rinses are

not likely to dissolve a biofilm, but will just kill the free-floating and

surface germs. (Note that nebulized antibiotics are better because they are more

concentrated, but they are not guaranteed at all to kill biofilms either ;

sometimes IV antibiotics are necessary, and sometimes a combination of the

above, and sometimes surgery is necessary).

So, using dilute antibiotic solutions for rinsing may give an initial feeling of

improvement - that may even last a few months - but, in my opinion, there is a

risk that this will eventually give way to a more resistant infection that will

prove very tough to treat.

This is why I am not really in favor of antibiotic rinses, except when used on a

short-term basis to treat an acute sinusitis.

On the idea of prevention, I am afraid this would not be very different from

taking oral antibiotics for prevention, which is not done because taking

antibiotics preventively will not protect anyone from catching future germs. It

may also disrupt without need the existing flora.

The only good approach with antibiotics and tough germs is to swab them, put

them into culture (assuming they grow, which is not granted), find the most

suitable antibiotic (or antifungal, etc), and take a course orally or through

nebulization, or even through IV if needed. If this fails repeatedly, it may

mean surgery is necessary to clear the infection.

Alternatively, vitamins, probiotics, sterile saline irrigation, allergy

desensitization, pneumococcal vaccine etc are good preventive measures.

>

> I am wondering if these are good to use periodically as a preventive measure.

Like every couple of months? Does anyone have any ideas on that?

>