Author(s)
Joel Franco, MD
Kaveh Karimnejad, MD
Adnan Husseini, MD
Antisdel Jastin, MD
Affiliation(s)
Saint Louis University
Abstract:
Introduction:Nasal drug delivery devices (NDDD) may act as reservoir for pathogenic bacteria. Studies have not examined the potential benefits of in vivo nozzle sanitization. Also, studies have not examined differences in the NDDD and the time before nozzle bacterial colonization. The purpose of the study was to examine patients using NDDD to establish the duration of use before colonization occurs, to determine if the type of device affects the rate of colonization, and to determine if isopropyl alcohol used in vivo has an effect on NDDD colonization.Methods:Patients with allergic rhinitis (AR) with and without chronic rhinosinusitis (CRS) over 4 months used a NDDD. Mechanical liquid spray pumps (LSP) and pressurized metered-dose inhalers (MDI) were used with and without sanitization with isopropyl alcohol. Culture swabs were obtained at days 10, 20, and 30 of each month.Results:MDI grew pathogenic bacteria by 10 days in 60% of samples (AR 33%, CRS 75%). LSP grew pathogenic bacteria by 15 days in 55% of samples (AR 13 days, 43%, CRS 17 days, 75%). In the AR group, daily cleansing with isopropyl alcohol eliminated the growth of pathogenic bacteria. No significant decrease was seen within the CRS group, or between devices. Conclusions:No significant difference was observed between MDI and LSP regarding overall time to bacterial colonization. The AR group demonstrated fewer samples colonized and a shorter time to colonization (LSP only). Isopropyl alcohol proved to be effective in preventing bacterial colonization in the AR group.