Aerosolized antibiotics refer to antibiotics delivered with a nebulizer directly to the sinuses. It has been proposed as a treatment for patients who have chronic sinusitis or acute exacerbations of chronic sinusitis.
Chronic sinusitis is defined as a group of disorders characterized by inflammation of the mucosa of the nose and paranasal sinuses of at least twelve consecutive weeks duration. Clinical signs include purulent drainage, and various imaging studies (i.e., computed tomography, magnetic resonance imaging or plain film radiography) may reveal polyps, edema, erythema, or granulation tissue of the sinuses. Chronic sinusitis may be associated with asthma, allergies, dental disease, polyposis, cystic fibrosis, and immunodeficiency syndromes. It is assumed that bacteria contribute to the pathophysiology of chronic sinusitis, but their exact contribution is still unclear. For example, chronic sinusitis probably represents a continuous spectrum of patho-physiologies ranging from a purely infectious etiology to non-infectious or allergic inflammation. In addition, it is possible that the presence of bacteria colonization may aggravate a noninfectious inflammation.
Conventional treatment for chronic sinusitis includes various combinations of oral antibiotics, decongestants, mucolytics, and topical corticosteroids. Endoscopic sinus surgery to improve the ventilation within the osteo meatal complex may be offered to those patients who fail medical management. After endoscopic sinus surgery, the sinus ostia are patent and communicate with the nasal cavity, thus offering an opportunity to deliver aerosolized antibiotics topically to the sinus cavities.
In June 2006, the LC® Star Reusable Nebulizer with Nasal Adapter (PARI Innovative Manufacturers, Inc.) was cleared for marketing by the U.S. Food and Drug Administration (FDA) through the 510(k) process. The FDA determined that this device was substantially equivalent to existing devices for the inhalation treatment of aerosolized medications.