The findings are reported in an article in the October issue of The Archives of Otolaryngology; Head & Neck Surgery, one of the JAMA/Archives journals.

Although the cause of CRS is controversial, one of the most likely culprits is bacterial infection, the article suggests. Guidelines recommend extended courses of antibiotics as a first-line treatment for CRS (chronic respiratory syndrome) before surgery is considered, the article notes.

Over a seven-year period, Neil Bhattacharyya, M.D., and Lynn J. Kepnes, R.N.P., of Brigham and Women's Hospital, Boston, investigated whether patients with CRS develop an increasing prevalence of antibiotic resistance over time.

Decreasing Resistance Noted

The researchers studied data on microbiological sinus culture results (224 culture results, average 2.5 cultures per patient) from 90 adult patients with CRS. The average time between cultures for patients was 157 days, and 429 organisms were isolated from the cultures. Patterns of antimicrobial resistance were identified.

"No statistically significant increase in severity of antimicrobial resistance was demonstrated within patients as serial cultures were drawn," the authors write. "In fact, a general trend toward decreasing antimicrobial resistance was noted overall, with many patients showing reversion to lesser degrees of antimicrobial resistance over time."

The authors attributed the lack of developing resistance to very specific use of antibiotics most often guided by culture results to confirm the type of bacteria and the need for antibiotics.