FCAAIA Notes: We are ALL guilty of over-prescribing antibiotics. Not everything that feels like it needs an antibiotic for relief does. Viral upper respiratory infections (colds), nasal allergies, and even barometric pressure changes can cause symptoms that mimic those of sinusitis. But, none will get better with an antibiotic.
Similarly, “bronchitis” is rarely a bacterial disease in non-smokers, especially young ones (young is defined as anyone younger than I am!). In fact, the most important thing that happens in asthma is inflammation of the bronchi (“bronchitis”) if you translate to Greek). Viral infections can also cause bronchitis.
There’s an old saying: “If I give you an antibiotic, this will get beet in a week. If I don’t, it will take seven days”. So, if we sometimes suggest waiting to use an antibiotic and trying other things first, there might be a good reason! Continue reading “INTERVENTIONS CURB ANTIBIOTIC SCRIPS IN THE SHORT-TERM”
FCAAIA Notes: Aspirin and medications related to it are collectively called nonsteroidal anti-inflammatory drugs (NSAIDs). As described in this article, a few different kinds of adverse reactions can occur. The most serious is called NSAID-exacerbated respiratory disease (NERD) and is characterized by severe asthma flares. It is particularly prevalent in those with nasal polyps and a history of severe asthma.
Of great importance, patients with NERD can be desensitized to aspirin. Because NERD is triggered by all the related drugs, aspirin desensitization effectively allows tolerance of all the NSAIDs. Furthermore, patients with NERD who undergo aspirin desensitization have better control of their nasal polyps and asthma.
In the past, aspirin desensitization was done in the hospital because of the risk of triggering a severe asthma exacerbation. Newer and MUCH safer protocols are available for in-office desensitization. In fact, we are now doing aspirin desensitization in our office Continue reading “ASPIRIN CHALLENGE AND DESENSITIZATION: How, When and Why”
FCAAIA Notes: So if it looks like a sinus infection, smells like a sinus infection, and eels like a sinus infection, it must be a sinus infection, right? Well, not necessarily. Every summary of chronic nasal and sinus disease will tell you that and that the overuse and abuse of antibiotics is common (Diagnosis and management of rhinosinusitis: A practice parameter update. Ann Allergy Asthma Immunol 2014; 113:347–385). If your symptoms do not clear with antibiotics, you have to start to wonder if there is something else going on. Continue reading “MANAGEMENT OF RHINOSINUSITIS: AN EVIDENCE BASED APPROACH”
FCAAIA Notes: Nasal saline (salt water) irrigations (NSI) are a simple and often useful means of diminishing symptoms related to allergic rhinitis, colds, and possible sinus infections. It is completely natural and essentially free. So, why not try it? You might find yourself using fewer colds medications and perhaps fewer antibiotics. Continue reading “NASAL IRRIGATION BENEFICIAL FOR SINUS SYMPTOMS, RCT SHOWS”