Repeat Antibiotic Usage and Antibiotic Associated Complications in Chronic Rhinosinusitis

Sunday, October 12, 2025

10:12 AM - 10:18 AM EDT

Location: 125

Disclosure(s):

Larry W. Wang, MS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Kevin C. Welch, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Chronic rhinosinusitis (CRS) is an inflammatory disorder of the paranasal sinuses and nasal cavity often treated with antibiotics, despite a paucity of literature demonstrating efficacy. This study aims to characterize the prevalence of repeat antibiotic usage and antibiotic-associated complications in CRS patients.

Methods: Patient data was queried from an institutional database (2006-2023) to identify CRS patients based on positive sinus computed tomography scans and International Classification of Diseases 9/10 codes. Primary outcome was prescription of repeat antibiotics (additional antibiotics prescribed within 30 days of initial antibiotic course) and secondary outcomes included Clostridium difficile (C. diff) infection or antibiotic allergy within 5 years of CRS diagnosis. Fisher’s exact test was performed to assess association between receipt of antibiotics and secondary outcomes.

Results: 22,592 CRS patients were included in the study. Of 10,340 (45.77%) patients that received a first-line antibiotic, 1305 (12.62%) received a repeat antibiotic course within 30 days. Amoxicillin-clavulanate was the most prescribed repeat antibiotic (23.98%) followed by levofloxacin (12.87%) and doxycycline (12.03%). Within 5 years of CRS diagnosis, 0.28% (n= 63) of patients had a C. diff infection with no significant difference based on receipt of antibiotics (Odds Ratio (OR), 1.15, 95% confidence interval (CI), 0.70-1.88, p= 0.614). For antibiotic allergy within 5-years, receipt of first-line or repeat antibiotic was a positive predictor (OR, 4.06, 95% CI, 3.48-4.73, p< 0.001).

Conclusions: Although antibiotic usage for CRS has decreased recently, the substantial utilization of first-line and repeat antibiotics may contribute to complications such as antibiotic allergy.

Presenting Author(s)

LW

Larry W. Wang, MS

Medical Student
Feinberg School of Medicine
Chicago, IL, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

AK

Atsushi Kato, PhD

Northwestern Feinberg School of Medicine, United States

Disclosure information not submitted.
WS

Whitney Stevens, MD

Northwestern Feinberg School of Medicine, United States

Disclosure information not submitted.
SS

Stephanie S. Smith, MD

Assistant Professor
Department of Otolaryngology-Head and Neck Surgery, Northwestern University
Chicago, IL, United States

Disclosure information not submitted.
BT

Bruce K. Tan, MD

Associate Professor
Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, U.S.A.
chicago, IL, United States

Disclosure information not submitted.
David B. Conley, MD

Associate Professor
Department of Otolaryngology - Head and Neck Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, U.S.A.
Chicago, IL, United States

Disclosure information not submitted.
KW

Kevin C. Welch, MD

Professor
Northwestern University Feinberg School of Medicine
Chicago, IL, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
LG

Leslie Grammar, MD

Northwestern Feinberg School of Medicine, United States

Disclosure information not submitted.
RS

Robert Schleimer, MD

Northwestern Feinberg School of Medicine, United States

Disclosure information not submitted.
Robert C. Kern, MD

George A. Sisson Professor and Chairman
Northwestern University Feinberg School of Medicine
Chicago, IL, United States

Disclosure information not submitted.

Senior Author(s)

Anju T. Peters, MD, MSCI

Professor of Medicine
Northwestern University Feinberg School of Medicine
Chicago, IL, United States

Disclosure information not submitted.