Bacteriological study of antibiotic sensitivity test in chronic rhinosinusitis before and during COVID-19

INTRODUCTION: Chronic rhinosinusitis (CRS) is an inflammation of the nasal mucosa and paranasal sinuses for more than 3 months that affects 5 to 12% of the quality of life. Antibiotics are the first line of management for CRS. Increased antibiotic resistance causes ineffective treatment of CRS. This study aims to determine the bacterial pattern that causes CRS before and during the COVID-19 pandemic. Culture sensitivity tests in rhinosinusitis patients were conducted to see changes in the bacterial resistance patterns to antibiotics before and during the COVID-19 pandemic and to determine the appropriate use of antibiotics and prevent an increase in antibiotic resistance in the ENT-HNS outward department of RSUP Dr. M. Djamil Padang.

MATERIALS AND METHODS: The type of research was a retrospective study with a total sample of 174 CRS patients who had undergone culture and sensitivity tests. The study population was all CRS patients who were treated at the ENT-HNS outward department at RSUP DR. M. Djamil Padang from 2016 to 2021, underwent surgery and received antibiotic treatment at secondary health services. Antibiotic sensitivity cultures are required for surgery and to determine antibiotics use after surgery. This research was conducted from February to May at the Tertiary Hospital of Dr. M. Djamil Padang. The data collection technique used a total sampling technique. The sample in this study was taken from the medical records of patients at the ENT-HNS outward department of RSUP Dr. M. Djamil Hospital, Padang.

RESULTS: The results showed that the prevalence of CRS with polyps before COVID-19 was 63.8% of cases. After COVID- 19, the prevalence of CRS with polyps was found to be 60% of cases. Before the COVID-19 pandemic, CRS was most common among those aged ≥ 41 to 50 years (27%) and the most common bacteria causing CRS with or without polyps was Staphylococcus aureus (39%; 44%). The bacteria causing CRS with or without polyps after COVID-19 were mostly Staphylococcus epidermidis (50% of cases). Before the COVID-19 pandemic, amoxicillin-clavulanic acid had a high resistance of 75 to 100%, however, after COVID-19 there was a change in antibiotic resistance patterns and an increase in ciprofloxacin resistance of 56 to 100% was obtained.

CONCLUSION: This change in antibiotic resistance pattern needs attention to prevent drug resistance, especially after COVID-19.