Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-27T21:00:46.800Z Has data issue: false hasContentIssue false
  • English
  • Français

Non-steroid, non-antibiotic anti-biofilm therapy for the treatment of chronic rhinosinusitis: a systematic review

Published online by Cambridge University Press:  05 March 2021

A Taylor ,
J Fuzi ,
A Sideris ,
C Banks  and
T E Havas
A Taylor*
Affiliation:
Department of Otolaryngology–Head and Neck Surgery, Prince of Wales Hospital, Sydney, Australia Department of Otolaryngology–Head and Neck Research Group, Prince of Wales Hospital, Sydney, Australia Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, Australia
J Fuzi
Affiliation:
Department of Otolaryngology–Head and Neck Surgery, Prince of Wales Hospital, Sydney, Australia Department of Otolaryngology–Head and Neck Research Group, Prince of Wales Hospital, Sydney, Australia Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, Australia
A Sideris
Affiliation:
Department of Otolaryngology–Head and Neck Surgery, Prince of Wales Hospital, Sydney, Australia Department of Otolaryngology–Head and Neck Research Group, Prince of Wales Hospital, Sydney, Australia Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, Australia
C Banks
Affiliation:
Department of Otolaryngology–Head and Neck Surgery, Prince of Wales Hospital, Sydney, Australia Department of Otolaryngology–Head and Neck Research Group, Prince of Wales Hospital, Sydney, Australia
T E Havas
Affiliation:
Department of Otolaryngology–Head and Neck Surgery, Prince of Wales Hospital, Sydney, Australia Department of Otolaryngology–Head and Neck Research Group, Prince of Wales Hospital, Sydney, Australia Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, Australia
*
Author for correspondence: Dr Alon Taylor, Department of Otolaryngology–Head and Neck Surgery, Outpatients A, Prince of Wales Hospital, Barker St, Randwick2031, Australia. E-mail: alon.taylor@health.nsw.gov.au
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

Chronic rhinosinusitis patients with biofilms cultured from their sinonasal cavity have greater symptom burden and risk of recalcitrant disease. A number of non-antibiotic, ‘anti-biofilm’ treatments exist which show anti-biofilm properties in preclinical studies. There is little evidence evaluating their impact on clinical symptom scores in chronic rhinosinusitis.

Method

A systematic review was performed to assess the literature regarding the efficacy of non-steroid, non-antibiotic, anti-biofilm specific topical therapies in the treatment of chronic rhinosinusitis. The primary outcome assessed was change in validated patient reported outcome measures before and after anti-biofilm treatment.

Results

Thirteen studies assessing the effect of anti-biofilm therapies in chronic rhinosinusitis through validated patient-reported outcome measures were included. Seven different anti-biofilm specific therapies for chronic rhinosinusitis were identified. None of the seven anti-biofilm therapies was identified as being confidently efficacious beyond placebo. Only one therapy (intranasal xylitol) showed a statistically significant reduction in symptom scores compared with placebo in more than one trial.

Conclusion

Robust evidence supporting the use of various anti-biofilm therapies in chronic rhinosinusitis is lacking. Further high quality, human, in vivo trials studying the effect of anti-biofilm therapies in chronic rhinosinusitis are needed to address the deficiencies of the current evidence base.

Keywords

Anti-Bacterial AgentsTherapeutic UseBiofilmsDrug EffectsChronic DiseaseHumansRhinitisSinusitisSurface-Active AgentsTreatment Outcome
Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 3 , March 2021 , pp. 196 - 205
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr A Taylor takes responsibility for the integrity of the content of the paper

References

Donlan, RM. Biofilms: Microbial life on surfaces. Emerg Infect Dis 2002;8:881–90CrossRefGoogle ScholarPubMed
Vestby, LK, Grønseth, T, Simm, R, Nesse, LL. Bacterial biofilm and its role in the pathogenesis of disease. Antibiotics 2020;9:59CrossRefGoogle ScholarPubMed
Głowacki, R, Tomaszewski, KA, Stre¸k, P, Tomaszewska, IM, Zgórska-Świerzy, K, Markiewicz, B et al. The influence of bacterial biofilm on the clinical outcome of chronic rhinosinusitis: a prospective, double-blind, scanning electron microscopy study. Eur Arch Otorhinolaryngol 2014;271:1015–21CrossRefGoogle ScholarPubMed
Psaltis, AJ, Weitzel, EK, Ha, KR, Wormald, PJ. The effect of bacterial biofilms on post-sinus surgical outcomes. Am J Rhinol 2008;22:1–6CrossRefGoogle ScholarPubMed
Singhal, D, Psaltis, AJ, Foreman, A, Wormald, PJ. The impact of biofilms on outcomes after endoscopic sinus surgery. Am J Rhinol Allergy 2010;24:169–74CrossRefGoogle ScholarPubMed
Zhang, Z, Linkin, DR, Finkelman, BS, O'Malley, BW Jr, Thaler, ER, Doghramji, L et al. Asthma and biofilm-forming bacteria are independently associated with revision sinus surgeries for chronic rhinosinusitis. J Allergy Clin Immunol 2011;128:221–3CrossRefGoogle ScholarPubMed
Rom, D, Bassiouni, A, Eykman, E, Liu, Z, Paramasivan, S, Alvarado, R et al. The association between disease severity and microbiome in chronic rhinosinusitis. Laryngoscope 2019;129:1265–73CrossRefGoogle ScholarPubMed
Orlandi, RR, Kingdom, TT, Hwang, PH, Smith, TL, Alt, JA, Baroody, FM et al. International consensus statement on allergy and rhinology: rhinosinusitis. Int Forum Allergy Rhinol 2016;6:S22–S209Google Scholar
Fokkens, WJ, Lund, VJ, Hopkins, C, Hellings, PW, Kern, R, Reitsma, S et al. European position paper on rhinosinusitis and nasal polyps 2020. Rhinology 2020;58:1–464CrossRefGoogle ScholarPubMed
Rudmik, L, Hopkins, C, Peters, A, Smith, TL, Schlosser, RJ, Soler, ZM. Patient-reported outcome measures for adult chronic rhinosinusitis: a systematic review and quality assessment. J Allergy Clin Immunol 2015;136:1532–40CrossRefGoogle ScholarPubMed
Kmet, LM, Lee, RC, Cook, LS. Standard quality assessment criteria for evaluating primary research papers from a variety of fields. Edmonton: Alberta Heritage Foundation for Medical Research, 2004Google Scholar
Scott, JR, Krishnan, R, Rotenberg, BW, Sowerby, LJ. The effectiveness of topical colloidal silver in recalcitrant chronic rhinosinusitis: a randomized crossover control trial. J Otolaryngol Head Neck Surg 2017;46:64CrossRefGoogle ScholarPubMed
Ooi, ML, Richter, K, Bennett, C, Macias-Valle, L, Vreugde, S, Psaltis, AJ et al. . Topical colloidal silver for the treatment of recalcitrant chronic rhinosinusitis. Front Microbiol 2018;9:720CrossRefGoogle ScholarPubMed
Ooi, ML, Jothin, A, Bennett, C, Ooi, EH, Vreugde, S, Psaltis, AJ et al. Manuka honey sinus irrigations in recalcitrant chronic rhinosinusitis: phase 1 randomized, single-blinded, placebo-controlled trial. Int Forum Allergy Rhinol 2019;9:1470–7CrossRefGoogle ScholarPubMed
Lee, VS, Humphreys, IM, Purcell, PL, Davis, GE. Manuka honey sinus irrigation for the treatment of chronic rhinosinusitis: a randomized controlled trial. Int Forum Allergy Rhinol 2017;7:365–72CrossRefGoogle ScholarPubMed
Hashemian, F, Baghbanian, N, Majd, Z, Rouini, MR, Jahanshahi, J, Hashemian, F. The effect of thyme honey nasal spray on chronic rhinosinusitis: a double-blind randomized controlled clinical trial. Eur Arch Otorhinolaryngol 2015;272:1429–35CrossRefGoogle ScholarPubMed
Farag, AA, Deal, AM, McKinney, KA, Thorp, BD, Senior, BA, Ebert, CS et al. Single-blind randomized controlled trial of surfactant vs hypertonic saline irrigation following endoscopic endonasal surgery. Int Forum Allergy Rhinol 2013;3:276–80CrossRefGoogle ScholarPubMed
Chiu, AG, Palmer, JN, Woodworth, BA, Doghramji, L, Cohen, MB, Prince, A et al. Baby shampoo nasal irrigations for the symptomatic post-functional endoscopic sinus surgery patient. Am J Rhinol 2008;22:34–7CrossRefGoogle ScholarPubMed
Jain, R, Lee, T, Hardcastle, T, Biswas, K, Radcliff, F, Douglas, R. The in vitro effect of xylitol on chronic rhinosinusitis biofilms. Rhinology 2016;54:323–8CrossRefGoogle ScholarPubMed
Lin, L, Tang, X, Wei, J, Dai, F, Sun, G. Xylitol nasal irrigation in the treatment of chronic rhinosinusitis. Am J Otolaryngol 2017;38:383–9CrossRefGoogle ScholarPubMed
Weissman, JD, Fernandez, F, Hwang, PH. Xylitol nasal irrigation in the management of chronic rhinosinusitis: a pilot study. Laryngoscope 2011;121:2468–72CrossRefGoogle ScholarPubMed
Petrovic Fabijan, A, Lin, RCY, Ho, J, Maddocks, S, Ben Zakour, NL, Iredell, JR et al. Safety of bacteriophage therapy in severe Staphylococcus aureus infection. Nat Microbiol 2020;5:465–472CrossRefGoogle ScholarPubMed
Ooi, ML, Drilling, AJ, Morales, S, Fong, S, Moraitis, S, Macias-Valle, L et al. Safety and tolerability of bacteriophage therapy for chronic rhinosinusitis due to staphylococcus aureus. JAMA Otolaryngol Head Neck Surg 2019;145:723–9CrossRefGoogle Scholar
Marcuzzo, AV, Tofanelli, M, Boscolo Nata, F, Gatto, A, Tirelli, G. Hyaluronate effect on bacterial biofilm in ENT district infections: a review. Apmis 2017;125:763–72CrossRefGoogle ScholarPubMed
Mozzanica, F, Preti, A, Gera, R, Bulgheroni, C, Cardella, A, Albera, A et al. Double-blind, randomised controlled trial on the efficacy of saline nasal irrigation with sodium hyaluronate after endoscopic sinus surgery. J Laryngol Otol 2019;133:300–8CrossRefGoogle ScholarPubMed
Cantone, E, Castagna, G, Sicignano, S, Ferranti, I, Rega, F, Di Rubbo, V et al. Impact of intranasal sodium hyaluronate on the short-term quality of life of patients undergoing functional endoscopic sinus surgery for chronic rhinosinusitis. Int Forum Allergy Rhinol 2014;4:484–7CrossRefGoogle ScholarPubMed
Young, D, Morton, R, Bartley, J. Therapeutic ultrasound as treatment for chronic rhinosinusitis: Preliminary observations. J Laryngol and Otol 2010;124:495–9CrossRefGoogle ScholarPubMed
Knight, R, Vrbanac, A, Taylor, BC, Aksenov, A, Callewaert, C, Debelius, J et al. Best practices for analysing microbiomes. Nat Rev Microbiol 2018;16:410–22CrossRefGoogle ScholarPubMed
Lam, K, Schleimer, R, Kern, RC. The etiology and pathogenesis of chronic rhinosinusitis: a review of current hypotheses. Curr Allergy Asthma 2015;15:41CrossRefGoogle ScholarPubMed
Fastenberg, JH, Hsueh, WD, Mustafa, A, Akbar, NA, Abuzeid, WM. Biofilms in chronic rhinosinusitis: pathophysiology and therapeutic strategies. World J Otorhinolaryng Head Neck Surg 2016;2:219–29CrossRefGoogle ScholarPubMed
Lee, S, Lane, AP. Chronic rhinosinusitis as a multifactorial inflammatory disorder. Curr Infect Dis Rep 2011;13:159–68CrossRefGoogle ScholarPubMed
Phillips, KM, Hoehle, LP, Caradonna, DS, Gray, ST, Sedaghat, AR. Minimal clinically important difference for the 22-item Sinonasal Outcome Test in medically managed patients with chronic rhinosinusitis. Clin Otolaryngol 2018;43:1328–34CrossRefGoogle ScholarPubMed
Bachert, C, Mannent, L, Naclerio, RM, Mullol, J, Ferguson, BJ, Gevaert, P et al. Effect of subcutaneous dupilumab on nasal polyp burden in patients with chronic sinusitis and nasal polyposis: a randomized clinical trial. JAMA 2016;315:469–79CrossRefGoogle ScholarPubMed
Bachert, C, Han, JK, Desrosiers, M, Hellings, PW, Amin, N, Lee, SE et al. Efficacy and safety of dupilumab in patients with severe chronic rhinosinusitis with nasal polyps (LIBERTY NP SINUS-24 and LIBERTY NP SINUS-52): results from two multicentre, randomised, double-blind, placebo-controlled, parallel-group phase 3 trials. Lancet 2019;394:1638–50CrossRefGoogle ScholarPubMed
Rajiv, S, Drilling, A, Bassiouni, A, James, C, Vreugde, S, Wormald, PJ. Topical colloidal silver as an anti-biofilm agent in a Staphylococcus aureus chronic rhinosinusitis sheep model. Int Forum Allergy Rhinol 2015;5:283–8CrossRefGoogle Scholar
Goggin, R, Jardeleza, C, Wormald, PJ, Vreugde, S. Colloidal silver: a novel treatment for staphylococcus aureus biofilms? Int Forum Allergy Rhinol 2014;4:171–5CrossRefGoogle ScholarPubMed
Paramasivan, S, Drilling, AJ, Jardeleza, C, Jervis-Bardy, J, Vreugde, S, Wormald, PJ. Methylglyoxal-augmented manuka honey as a topical anti-Staphylococcus aureus biofilm agent: safety and efficacy in an in vivo model. Int Forum Allergy Rhinol 2014;4:187–95CrossRefGoogle Scholar
Alandejani, T, Marsan, J, Ferris, W, Slinger, R, Chan, F. Effectiveness of honey on staphylococcus aureus and pseudomonas aeruginosa biofilms. Otolaryngol Head Neck Surg 2009;141:114–18CrossRefGoogle ScholarPubMed
Belfield, K, Bayston, R, Hajduk, N, Levell, G, Birchall, JP, Daniel, M. Evaluation of combinations of putative anti-biofilm agents and antibiotics to eradicate biofilms of Staphylococcus aureus and Pseudomonas aeruginosa. J Antimicrob Chemother 2017;72:2531–8CrossRefGoogle ScholarPubMed
Drago, L, Cappelletti, L, De Vecchi, E, Pignataro, L, Torretta, S, Mattina, R. Antiadhesive and antibiofilm activity of hyaluronic acid against bacteria responsible for respiratory tract infections. Apmis 2014;122:1013–19CrossRefGoogle ScholarPubMed
Fong, SA, Drilling, A, Morales, S, Cornet, ME, Woodworth, BA, Fokkens, WJ et al. . Activity of bacteriophages in removing biofilms of pseudomonas aeruginosa isolates from chronic rhinosinusitis patients. Front Cell Infect Microbiol 2017;7:418CrossRefGoogle ScholarPubMed
Zhang, G, Zhao, Y, Paramasivan, S, Richter, K, Morales, S, Wormald, PJ et al. Bacteriophage effectively kills multidrug resistant Staphylococcus aureus clinical isolates from chronic rhinosinusitis patients. Int Forum Allergy Rhinol 2018;8:406–14CrossRefGoogle ScholarPubMed
Karosi, T, Sziklai, I, Csomor, P. Low-frequency ultrasound for biofilm disruption in chronic rhinosinusitis with nasal polyposis: in vitro pilot study. Laryngoscope 2013;123:17–23CrossRefGoogle ScholarPubMed