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이봉재,지부환,이석우 대한비과학회 1999 Journal of rhinology Vol.6 No.1
The aim of this study was to identify the pathogens of chronic recalcitrant sinusitis and to obtain information for determiningappropriate antibiotics through sensitivity testing. A prospective study was conducted on 100 patients with chronic sinusitis whohad undergone endoscopic sinus surgery after failed medical treatment. Specimens were obtained from the maxillary sinuses andsent for bacterial cultures and sensitivity tests. Bacteria were isolated in 75 (75%) of the 100 cases. Aerobic bacteria were isolatedin 73 cases (73%). Gram-positive aerobes were recovered in 54 cases (54%) and Gram-negative aerobes in 20 cases (20%). Anaerobes were isolated in three cases (3%). Mixed infections were found in two cases (2%). More than 90% of the aerobicbacteria were resistant to penicillin, and 48.8% of the Staphylococci were resistant to oxacillin. Seventy percent of Gram-positiveaerobes were sensitive to trimethoprim-sulfamethoxazole, 75% to clindamycin, and 93% to ciprofloxacin. Ninety percent of Gramnegativeaerobes were sensitive to ciprofloxacin, and 95% to trimethoprim-sulfamethoxazole. In conclusion, most of the isolatedbacteria were aerobic, and in contrast to previous reports, mixed or anaerobic bacterial infection was not frequent. Among theoral antibiotics tested for sensitivity in this study, ciprofloxacin, trimethoprim-sulfamethoxazole, and clindamycin are most stronglyrecommended for treating chronic sinusitis refractory to first-line antibiotic treatment.