I saw my ENT doctor this week, he had just gotten back from the annual meeting of ENT specialists (don't know what they call themselves), and apparenlty someone presented a study on the role biofilms play in chronic sinusitis/infections and how to treat them. I know there has been a lot of discussion on biofilms here, so I'm glad to see it had hit the mainstream ENT community.
Anyway, the recommended treatment is irrigating the sinuses with a solution of warm water and Johnson's baby shampoo. Proportions are 100:1, water to shampoo. His recommendation is 1/2 tsp in a 250 ml nasal squirt bottle, the McNeil kind you buy in CVS, Wal-Mart, etc.
I've done it twice so far, and to be honest, it was most unpleasant squirting soapy water up my nose. (I added 1/2 tsp. of salt, which helped.) But no antibiotics seem to be able to eradicate my pseudomonas, so I'mm going to bite the bullet and do it once a day.
Wish I could give you the study citation, but I don't have it. But baby shampoo is what they used.
Am J Rhinol. 2008 Jan-Feb;22(1):34-7.Click here to read Links Baby shampoo nasal irrigations for the symptomatic post-functional endoscopic sinus surgery patient. Chiu AG, Palmer JN, Woodworth BA, Doghramji L, Cohen MB, Prince A, Cohen NA.
Division of Rhinology, Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA. Alexander.c...@uphs.upenn.edu BACKGROUND: Symptoms of postnasal drainage and thickened mucus are commonly seen in patients with chronic rhinosinusitis (CRS) recalcitrant to sinus surgery and conventional medical therapies. Chemical surfactants can act as a mucolytic by reducing water surface tension and have the potential to serve as an antimicrobial agent. Baby shampoo is an inexpensive, commercially available solution containing multiple chemical surfactants. This is an in vitro study of its antimicrobial effects on Pseudomonas biofilms with translation to a clinical study for use as an adjuvant nasal wash in patients with CRS who remain symptomatic despite adequate sinus surgery and conventional medical therapies. METHODS: In vitro testing was performed to determine the optimal concentration of baby shampoo that disrupted preformed bacterial biofilms and inhibited biofilm formation. This concentration was then used in a prospective study of symptomatic post-functional endoscopic sinus surgery (FESS) patients who irrigated twice a day for 4 weeks. Validated outcome forms and objective smell testing was performed before and after therapy. RESULTS: One percent baby shampoo in normal saline was the optimal concentration for inhibition of Pseudomonas biofilm formation. ==> Baby shampoo had no effect on the eradication of preformed Pseudomonas biofilms. <== Eighteen patients with CRS with an average of 2.8 surgeries were studied after irrigating with 1% baby shampoo solution. Two patients discontinued use because of minor nasal and skin irritations; 46.6% of patients experienced an overall improvement in their subjective symptoms, and 60% of patients noted improvement in specific symptoms of thickened mucus and postnasal drainage. CONCLUSION: Baby shampoo nasal irrigation has promise as an inexpensive, tolerable adjuvant to conventional medical therapies for symptomatic patients after FESS. Its greatest benefit may be in improving symptoms of thickened nasal discharge and postnasal drainage.
Am J Rhinol. 2008 Nov-Dec;22(6):560-7.Click here to read Links The efficacy of topical antibiofilm agents in a sheep model of rhinosinusitis. Le T, Psaltis A, Tan LW, Wormald PJ. Department of Surgery-Otolaryngology Head and Neck Surgery, University of Adelaide, Adelaide, Australia. BACKGROUND: Biofilms have been shown to be resistant to conventional antibiotic treatment. This study uses a sheep biofilm model developed by our department to investigate several novel topical anti-biofilm treatments. METHODS: Staphylococcal biofilms were grown in 54 sheep frontal sinuses over 8 days: Each sinus was randomized to (1) no intervention, (2) single mupirocin flush, (3) regular 12-hourly mupirocin flushes for 5 days, (4) Citric Acid Zwitterionic Surfactant (CAZS) via hydrodebrider, (5) gallium nitrate, (6) CAZS with gallium nitrate, (7) CAZS with mupirocin, and (8) saline regular flushes. Sheep were sacrificed and the sinus mucosa harvested 1 or 8 days after treatment to assess treatment and any biofilm regrowth. Confocal scanning laser microscopy was used to confirm the presence or absence of biofilms, and the extent of biofilm reduction was quantitated using fluorescent in situ hybridization and colony forming unit counts. RESULTS: In the control sheep biofilm coverage averaged 31.7%. Saline and mupirocin b.d. washes for 5 days had 23% and 0.84% coverage, respectively, when harvested on day 8. A single mupirocin and gallium wash had 7.7% and 16.2% on day 1 and 5.88% and 16.0% on day 8. CAZS with hydrodebrider had 6.66% on day 1 but 21.95% on day 8 whereas CAZS with hydodebrider and gallium had 13.3% on day 8. CONCLUSION: This study shows that regular treatment with mupirocin produced the most marked reduction in biofilm surface area coverage (0.84% and 1.25%) with sustained effects over the 8-day follow-up period.
On 18 oct, 06:19, potatotree <braecan...@aol.com> wrote:
> I saw my ENT doctor this week, he had just gotten back from the annual > meeting of ENT specialists (don't know what they call themselves), and > apparenlty someone presented a study on the role biofilms play in > chronic sinusitis/infections and how to treat them. I know there has > been a lot of discussion on biofilms here, so I'm glad to see it had > hit the mainstream ENT community.
> Anyway, the recommended treatment is irrigating the sinuses with a > solution of warm water and Johnson's baby shampoo. Proportions are > 100:1, water to shampoo. His recommendation is 1/2 tsp in a 250 ml > nasal squirt bottle, the McNeil kind you buy in CVS, Wal-Mart, etc.
> I've done it twice so far, and to be honest, it was most unpleasant > squirting soapy water up my nose. (I added 1/2 tsp. of salt, which > helped.) But no antibiotics seem to be able to eradicate my > pseudomonas, so I'mm going to bite the bullet and do it once a day.
> Wish I could give you the study citation, but I don't have it. But > baby shampoo is what they used.
I have been using baby shampoo in my saline nasal irrigation solution for a year or so and have not noticed any major improvement, but no real problems either.
Andrew
"potatotree" <braecan...@aol.com> wrote in message
> I saw my ENT doctor this week, he had just gotten back from the annual > meeting of ENT specialists (don't know what they call themselves), and > apparenlty someone presented a study on the role biofilms play in > chronic sinusitis/infections and how to treat them. I know there has > been a lot of discussion on biofilms here, so I'm glad to see it had > hit the mainstream ENT community.
> Anyway, the recommended treatment is irrigating the sinuses with a > solution of warm water and Johnson's baby shampoo. Proportions are > 100:1, water to shampoo. His recommendation is 1/2 tsp in a 250 ml > nasal squirt bottle, the McNeil kind you buy in CVS, Wal-Mart, etc.
> I've done it twice so far, and to be honest, it was most unpleasant > squirting soapy water up my nose. (I added 1/2 tsp. of salt, which > helped.) But no antibiotics seem to be able to eradicate my > pseudomonas, so I'mm going to bite the bullet and do it once a day.
> Wish I could give you the study citation, but I don't have it. But > baby shampoo is what they used.
AB wrote: > I have been using baby shampoo in my saline nasal irrigation solution for a > year or so and have not noticed any major improvement, but no real problems > either.
> Andrew
That's probably because "Baby shampoo had no effect on the eradication of preformed Pseudomonas biofilms."
On Oct 21, 7:15 pm, sbnjhfty <fgsdf...@asfffwer.com> wrote:
> AB wrote: > > I have been using baby shampoo in my saline nasal irrigation solution for a > > year or so and have not noticed any major improvement, but no real problems > > either.
> > Andrew
> That's probably because "Baby shampoo had no effect on the > eradication of preformed Pseudomonas biofilms."
None so effective as strong black tea or pecan membrane tea.
On Oct 23, 9:30 pm, truehawk <trueha...@yahoo.com> wrote:
> On Oct 21, 7:15 pm, sbnjhfty <fgsdf...@asfffwer.com> wrote:
> > AB wrote: > > > I have been using baby shampoo in my saline nasal irrigation solution for a > > > year or so and have not noticed any major improvement, but no real problems > > > either.
> > > Andrew
> > That's probably because "Baby shampoo had no effect on the > > eradication of preformed Pseudomonas biofilms."
> None so effective as strong black tea or pecan membrane tea.
Re: That's probably because "Baby shampoo had no effect on the
> > eradication of preformed Pseudomonas biofilms."
Can you tell me where this is from?
Also, anyone heard of using MSM (Methyl-Sulfonyl-Methane), dissolved in a saline rinse?
potatotree wrote: > On Oct 23, 9:30 pm, truehawk <trueha...@yahoo.com> wrote: >> On Oct 21, 7:15 pm, sbnjhfty <fgsdf...@asfffwer.com> wrote:
>>> AB wrote: >>>> I have been using baby shampoo in my saline nasal irrigation solution for a >>>> year or so and have not noticed any major improvement, but no real problems >>>> either. >>>> Andrew >>> That's probably because "Baby shampoo had no effect on the >>> eradication of preformed Pseudomonas biofilms." >> None so effective as strong black tea or pecan membrane tea.
> Re: That's probably because "Baby shampoo had no effect on the >>> eradication of preformed Pseudomonas biofilms."
> Can you tell me where this is from?
It was a direct quote out of the article that was posted.
> Also, anyone heard of using MSM (Methyl-Sulfonyl-Methane), dissolved > in a saline rinse?
> potatotree wrote: > > On Oct 23, 9:30 pm, truehawk <trueha...@yahoo.com> wrote: > >> On Oct 21, 7:15 pm, sbnjhfty <fgsdf...@asfffwer.com> wrote:
> >>> AB wrote: > >>>> I have been using baby shampoo in my saline nasal irrigation solution for a > >>>> year or so and have not noticed any major improvement, but no real problems > >>>> either. > >>>> Andrew > >>> That's probably because "Baby shampoo had no effect on the > >>> eradication of preformed Pseudomonas biofilms." > >> None so effective as strong black tea or pecan membrane tea.
> > Re: That's probably because "Baby shampoo had no effect on the > >>> eradication of preformed Pseudomonas biofilms."
> > Can you tell me where this is from?
> It was a direct quote out of the article that was posted.
> > Also, anyone heard of using MSM (Methyl-Sulfonyl-Methane), dissolved > > in a saline rinse?
> Not me.- Hide quoted text -
> - Show quoted text -
Right you are. Thanks for pointing that out. I hated the baby shampoo anyway.
Now I need to figure out the right concentration for the black tea. I think I went overboard and gave myself the equivalent of a chemical facial peel inside my sinuses. But I'm sure it "disrupted" my biofilms.
In this study, did they have a control group who irrigated, without the baby shampoo? Do the 46.6% and 60% figures cited involve a comparison between two groups, that both irrigated with saline, with one having the baby shampoo added?
If not-- if the baby shampoo irrigators were compared with non-irrigators, the results are absolutely meaningless. Irrigating will definitely improve symptoms, clear away phlegm, etc., shampoo or not.
The best way, in fact, would be for the test to be blind, in other words for both groups of irrigators not to know whether their solution contains the shampoo or not, so as not to be influenced by psychological factors, placebo effect, etc. But I guess that would probably be impossible in this case, due to the taste.
I doubt there have been any studies yet, of what long-term negative effects might be, of sniffing such soapy chemicals into your nose and sinuses every day for years!
> Am J Rhinol. 2008 Jan-Feb;22(1):34-7.Click here to read Links > Baby shampoo nasal irrigations for the symptomatic post-functional > endoscopic sinus surgery patient. > Chiu AG, Palmer JN, Woodworth BA, Doghramji L, Cohen MB, Prince A, > Cohen NA.
> Division of Rhinology, Department of Otorhinolaryngology-Head and > Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania > 19104, USA. Alexander.c...@uphs.upenn.edu > BACKGROUND: Symptoms of postnasal drainage and thickened mucus are > commonly seen in patients with chronic rhinosinusitis (CRS) > recalcitrant to sinus surgery and conventional medical therapies. > Chemical surfactants can act as a mucolytic by reducing water surface > tension and have the potential to serve as an antimicrobial agent. > Baby shampoo is an inexpensive, commercially available solution > containing multiple chemical surfactants. This is an in vitro study of > its antimicrobial effects on Pseudomonas biofilms with translation to > a clinical study for use as an adjuvant nasal wash in patients with > CRS who remain symptomatic despite adequate sinus surgery and > conventional medical therapies. > METHODS: In vitro testing was performed to determine the optimal > concentration of baby shampoo that disrupted preformed bacterial > biofilms and inhibited biofilm formation. This concentration was then > used in a prospective study of symptomatic post-functional endoscopic > sinus surgery (FESS) patients who irrigated twice a day for 4 weeks. > Validated outcome forms and objective smell testing was performed > before and after therapy. > RESULTS: One percent baby shampoo in normal saline was the optimal > concentration for inhibition of Pseudomonas biofilm formation. ==> > Baby shampoo had no effect on the eradication of preformed Pseudomonas > biofilms. <== > Eighteen patients with CRS with an average of 2.8 surgeries were > studied after irrigating with 1% baby shampoo solution. Two patients > discontinued use because of minor nasal and skin irritations; 46.6% of > patients experienced an overall improvement in their subjective > symptoms, and 60% of patients noted improvement in specific symptoms > of thickened mucus and postnasal drainage. > CONCLUSION: Baby shampoo nasal irrigation has promise as an > inexpensive, tolerable adjuvant to conventional medical therapies for > symptomatic patients after FESS. Its greatest benefit may be in > improving symptoms of thickened nasal discharge and postnasal > drainage.
> Am J Rhinol. 2008 Nov-Dec;22(6):560-7.Click here to read Links > The efficacy of topical antibiofilm agents in a sheep model of > rhinosinusitis. > Le T, Psaltis A, Tan LW, Wormald PJ. > Department of Surgery-Otolaryngology Head and Neck Surgery, > University of Adelaide, Adelaide, Australia. > BACKGROUND: Biofilms have been shown to be resistant to > conventional antibiotic treatment. This study uses a sheep biofilm > model developed by our department to investigate several novel topical > anti-biofilm treatments. METHODS: Staphylococcal biofilms were grown > in 54 sheep frontal sinuses over 8 days: Each sinus was randomized to > (1) no intervention, (2) single mupirocin flush, (3) regular 12-hourly > mupirocin flushes for 5 days, (4) Citric Acid Zwitterionic Surfactant > (CAZS) via hydrodebrider, (5) gallium nitrate, (6) CAZS with gallium > nitrate, (7) CAZS with mupirocin, and (8) saline regular flushes. > Sheep were sacrificed and the sinus mucosa harvested 1 or 8 days after > treatment to assess treatment and any biofilm regrowth. Confocal > scanning laser microscopy was used to confirm the presence or absence > of biofilms, and the extent of biofilm reduction was quantitated using > fluorescent in situ hybridization and colony forming unit counts. > RESULTS: In the control sheep biofilm coverage averaged 31.7%. Saline > and mupirocin b.d. washes for 5 days had 23% and 0.84% coverage, > respectively, when harvested on day 8. A single mupirocin and gallium > wash had 7.7% and 16.2% on day 1 and 5.88% and 16.0% on day 8. CAZS > with hydrodebrider had 6.66% on day 1 but 21.95% on day 8 whereas CAZS > with hydodebrider and gallium had 13.3% on day 8. CONCLUSION: This > study shows that regular treatment with mupirocin produced the most > marked reduction in biofilm surface area coverage (0.84% and 1.25%) > with sustained effects over the 8-day follow-up period.
> On 18 oct, 06:19, potatotree <braecan...@aol.com> wrote: >> I saw my ENT doctor this week, he had just gotten back from the annual >> meeting of ENT specialists (don't know what they call themselves), and >> apparenlty someone presented a study on the role biofilms play in >> chronic sinusitis/infections and how to treat them. I know there has >> been a lot of discussion on biofilms here, so I'm glad to see it had >> hit the mainstream ENT community.
>> Anyway, the recommended treatment is irrigating the sinuses with a >> solution of warm water and Johnson's baby shampoo. Proportions are >> 100:1, water to shampoo. His recommendation is 1/2 tsp in a 250 ml >> nasal squirt bottle, the McNeil kind you buy in CVS, Wal-Mart, etc.
>> I've done it twice so far, and to be honest, it was most unpleasant >> squirting soapy water up my nose. (I added 1/2 tsp. of salt, which >> helped.) But no antibiotics seem to be able to eradicate my >> pseudomonas, so I'mm going to bite the bullet and do it once a day.
>> Wish I could give you the study citation, but I don't have it. But >> baby shampoo is what they used.
>I have been using baby shampoo in my saline nasal irrigation solution for a >year or so and have not noticed any major improvement, but no real problems >either.
>> I saw my ENT doctor this week, he had just gotten back from the annual >> meeting of ENT specialists (don't know what they call themselves), and >> apparenlty someone presented a study on the role biofilms play in >> chronic sinusitis/infections and how to treat them. I know there has >> been a lot of discussion on biofilms here, so I'm glad to see it had >> hit the mainstream ENT community.
>> Anyway, the recommended treatment is irrigating the sinuses with a >> solution of warm water and Johnson's baby shampoo. Proportions are >> 100:1, water to shampoo. His recommendation is 1/2 tsp in a 250 ml >> nasal squirt bottle, the McNeil kind you buy in CVS, Wal-Mart, etc.
>> I've done it twice so far, and to be honest, it was most unpleasant >> squirting soapy water up my nose. (I added 1/2 tsp. of salt, which >> helped.) But no antibiotics seem to be able to eradicate my >> pseudomonas, so I'mm going to bite the bullet and do it once a day.
>> Wish I could give you the study citation, but I don't have it. But >> baby shampoo is what they used.
> Why do you continue with baby shampoo in your irrigation fluid, if you > have not noticed improvement from it?
> I think it is unavoidable when irrigating, that some solution goes down > the throat. Must be pretty yukky to drink soap!
> "AB" <ab...@yahoo.com> wrote in message > news:4adee851$0$6094$afc38c87@news.optusnet.com.au... >>I have been using baby shampoo in my saline nasal irrigation solution for >>a year or so and have not noticed any major improvement, but no real >>problems either.
>>> I saw my ENT doctor this week, he had just gotten back from the annual >>> meeting of ENT specialists (don't know what they call themselves), and >>> apparenlty someone presented a study on the role biofilms play in >>> chronic sinusitis/infections and how to treat them. I know there has >>> been a lot of discussion on biofilms here, so I'm glad to see it had >>> hit the mainstream ENT community.
>>> Anyway, the recommended treatment is irrigating the sinuses with a >>> solution of warm water and Johnson's baby shampoo. Proportions are >>> 100:1, water to shampoo. His recommendation is 1/2 tsp in a 250 ml >>> nasal squirt bottle, the McNeil kind you buy in CVS, Wal-Mart, etc.
>>> I've done it twice so far, and to be honest, it was most unpleasant >>> squirting soapy water up my nose. (I added 1/2 tsp. of salt, which >>> helped.) But no antibiotics seem to be able to eradicate my >>> pseudomonas, so I'mm going to bite the bullet and do it once a day.
>>> Wish I could give you the study citation, but I don't have it. But >>> baby shampoo is what they used.
> In this study, did they have a control group who irrigated, without the baby > shampoo? Do the 46.6% and 60% figures cited involve a comparison between two > groups, that both irrigated with saline, with one having the baby shampoo > added?
> If not-- if the baby shampoo irrigators were compared with non-irrigators, > the results are absolutely meaningless. Irrigating will definitely improve > symptoms, clear away phlegm, etc., shampoo or not.
> The best way, in fact, would be for the test to be blind, in other words for > both groups of irrigators not to know whether their solution contains the > shampoo or not, so as not to be influenced by psychological factors, placebo > effect, etc. But I guess that would probably be impossible in this case, due > to the taste.
> I doubt there have been any studies yet, of what long-term negative effects > might be, of sniffing such soapy chemicals into your nose and sinuses every > day for years!
> > Am J Rhinol. 2008 Jan-Feb;22(1):34-7.Click here to read Links > > Baby shampoo nasal irrigations for the symptomatic post-functional > > endoscopic sinus surgery patient. > > Chiu AG, Palmer JN, Woodworth BA, Doghramji L, Cohen MB, Prince A, > > Cohen NA.
> > Division of Rhinology, Department of Otorhinolaryngology-Head and > > Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania > > 19104, USA. Alexander.c...@uphs.upenn.edu > > BACKGROUND: Symptoms of postnasal drainage and thickened mucus are > > commonly seen in patients with chronic rhinosinusitis (CRS) > > recalcitrant to sinus surgery and conventional medical therapies. > > Chemical surfactants can act as a mucolytic by reducing water surface > > tension and have the potential to serve as an antimicrobial agent. > > Baby shampoo is an inexpensive, commercially available solution > > containing multiple chemical surfactants. This is an in vitro study of > > its antimicrobial effects on Pseudomonas biofilms with translation to > > a clinical study for use as an adjuvant nasal wash in patients with > > CRS who remain symptomatic despite adequate sinus surgery and > > conventional medical therapies. > > METHODS: In vitro testing was performed to determine the optimal > > concentration of baby shampoo that disrupted preformed bacterial > > biofilms and inhibited biofilm formation. This concentration was then > > used in a prospective study of symptomatic post-functional endoscopic > > sinus surgery (FESS) patients who irrigated twice a day for 4 weeks. > > Validated outcome forms and objective smell testing was performed > > before and after therapy. > > RESULTS: One percent baby shampoo in normal saline was the optimal > > concentration for inhibition of Pseudomonas biofilm formation. ==> > > Baby shampoo had no effect on the eradication of preformed Pseudomonas > > biofilms. <== > > Eighteen patients with CRS with an average of 2.8 surgeries were > > studied after irrigating with 1% baby shampoo solution. Two patients > > discontinued use because of minor nasal and skin irritations; 46.6% of > > patients experienced an overall improvement in their subjective > > symptoms, and 60% of patients noted improvement in specific symptoms > > of thickened mucus and postnasal drainage. > > CONCLUSION: Baby shampoo nasal irrigation has promise as an > > inexpensive, tolerable adjuvant to conventional medical therapies for > > symptomatic patients after FESS. Its greatest benefit may be in > > improving symptoms of thickened nasal discharge and postnasal > > drainage.
> > Am J Rhinol. 2008 Nov-Dec;22(6):560-7.Click here to read Links > > The efficacy of topical antibiofilm agents in a sheep model of > > rhinosinusitis. > > Le T, Psaltis A, Tan LW, Wormald PJ. > > Department of Surgery-Otolaryngology Head and Neck Surgery, > > University of Adelaide, Adelaide, Australia. > > BACKGROUND: Biofilms have been shown to be resistant to > > conventional antibiotic treatment. This study uses a sheep biofilm > > model developed by our department to investigate several novel topical > > anti-biofilm treatments. METHODS: Staphylococcal biofilms were grown > > in 54 sheep frontal sinuses over 8 days: Each sinus was randomized to > > (1) no intervention, (2) single mupirocin flush, (3) regular 12-hourly > > mupirocin flushes for 5 days, (4) Citric Acid Zwitterionic Surfactant > > (CAZS) via hydrodebrider, (5) gallium nitrate, (6) CAZS with gallium > > nitrate, (7) CAZS with mupirocin, and (8) saline regular flushes. > > Sheep were sacrificed and the sinus mucosa harvested 1 or 8 days after > > treatment to assess treatment and any biofilm regrowth. Confocal > > scanning laser microscopy was used to confirm the presence or absence > > of biofilms, and the extent of biofilm reduction was quantitated using > > fluorescent in situ hybridization and colony forming unit counts. > > RESULTS: In the control sheep biofilm coverage averaged 31.7%. Saline > > and mupirocin b.d. washes for 5 days had 23% and 0.84% coverage, > > respectively, when harvested on day 8. A single mupirocin and gallium > > wash had 7.7% and 16.2% on day 1 and 5.88% and 16.0% on day 8. CAZS > > with hydrodebrider had 6.66% on day 1 but 21.95% on day 8 whereas CAZS > > with hydodebrider and gallium had 13.3% on day 8. CONCLUSION: This > > study shows that regular treatment with mupirocin produced the most > > marked reduction in biofilm surface area coverage (0.84% and 1.25%) > > with sustained effects over the 8-day follow-up period.
> > On 18 oct, 06:19, potatotree <braecan...@aol.com> wrote: > >> I saw my ENT doctor this week, he had just gotten back from the annual > >> meeting of ENT specialists (don't know what they call themselves), and > >> apparenlty someone presented a study on the role biofilms play in > >> chronic sinusitis/infections and how to treat them. I know there has > >> been a lot of discussion on biofilms here, so I'm glad to see it had > >> hit the mainstream ENT community.
> >> Anyway, the recommended treatment is irrigating the sinuses with a > >> solution of warm water and Johnson's baby shampoo. Proportions are > >> 100:1, water to shampoo. His recommendation is 1/2 tsp in a 250 ml > >> nasal squirt bottle, the McNeil kind you buy in CVS, Wal-Mart, etc.
> >> I've done it twice so far, and to be honest, it was most unpleasant > >> squirting soapy water up my nose. (I added 1/2 tsp. of salt, which > >> helped.) But no antibiotics seem to be able to eradicate my > >> pseudomonas, so I'mm going to bite the bullet and do it once a day.
> >> Wish I could give you the study citation, but I don't have it. But > >> baby shampoo is what they used.- Hide quoted text -
> - Show quoted text -
The baby shampoo irrigation seems to work best for people who have congestion or a discharge in their sinuses, from what I understand. I emailed one of the researchers on the baby shampoo study and he confirmed that it only worked to prevent the formation of biofilms. Not effective for existing biofilms. As for other biofilm disruptors, well, there's plenty of them, he said, but they cause collateral damage. I can attest to that, Lukewarm black tea mixed with saline wiped out my pseudomas symptoms, st least temporarily, but it completely plugged up my nose for two weeks.
> On Nov 27, 12:18 pm, "MS" <m...@nospam.com> wrote:
> > One thing I am not clear on:
> > In this study, did they have a control group who irrigated, without the baby > > shampoo? Do the 46.6% and 60% figures cited involve a comparison between two > > groups, that both irrigated with saline, with one having the baby shampoo > > added?
> > If not-- if the baby shampoo irrigators were compared with non-irrigators, > > the results are absolutely meaningless. Irrigating will definitely improve > > symptoms, clear away phlegm, etc., shampoo or not.
> > The best way, in fact, would be for the test to be blind, in other words for > > both groups of irrigators not to know whether their solution contains the > > shampoo or not, so as not to be influenced by psychological factors, placebo > > effect, etc. But I guess that would probably be impossible in this case, due > > to the taste.
> > I doubt there have been any studies yet, of what long-term negative effects > > might be, of sniffing such soapy chemicals into your nose and sinuses every > > day for years!
> > > Am J Rhinol. 2008 Jan-Feb;22(1):34-7.Click here to read Links > > > Baby shampoo nasal irrigations for the symptomatic post-functional > > > endoscopic sinus surgery patient. > > > Chiu AG, Palmer JN, Woodworth BA, Doghramji L, Cohen MB, Prince A, > > > Cohen NA.
> > > Division of Rhinology, Department of Otorhinolaryngology-Head and > > > Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania > > > 19104, USA. Alexander.c...@uphs.upenn.edu > > > BACKGROUND: Symptoms of postnasal drainage and thickened mucus are > > > commonly seen in patients with chronic rhinosinusitis (CRS) > > > recalcitrant to sinus surgery and conventional medical therapies. > > > Chemical surfactants can act as a mucolytic by reducing water surface > > > tension and have the potential to serve as an antimicrobial agent. > > > Baby shampoo is an inexpensive, commercially available solution > > > containing multiple chemical surfactants. This is an in vitro study of > > > its antimicrobial effects on Pseudomonas biofilms with translation to > > > a clinical study for use as an adjuvant nasal wash in patients with > > > CRS who remain symptomatic despite adequate sinus surgery and > > > conventional medical therapies. > > > METHODS: In vitro testing was performed to determine the optimal > > > concentration of baby shampoo that disrupted preformed bacterial > > > biofilms and inhibited biofilm formation. This concentration was then > > > used in a prospective study of symptomatic post-functional endoscopic > > > sinus surgery (FESS) patients who irrigated twice a day for 4 weeks. > > > Validated outcome forms and objective smell testing was performed > > > before and after therapy. > > > RESULTS: One percent baby shampoo in normal saline was the optimal > > > concentration for inhibition of Pseudomonas biofilm formation. ==> > > > Baby shampoo had no effect on the eradication of preformed Pseudomonas > > > biofilms. <== > > > Eighteen patients with CRS with an average of 2.8 surgeries were > > > studied after irrigating with 1% baby shampoo solution. Two patients > > > discontinued use because of minor nasal and skin irritations; 46.6% of > > > patients experienced an overall improvement in their subjective > > > symptoms, and 60% of patients noted improvement in specific symptoms > > > of thickened mucus and postnasal drainage. > > > CONCLUSION: Baby shampoo nasal irrigation has promise as an > > > inexpensive, tolerable adjuvant to conventional medical therapies for > > > symptomatic patients after FESS. Its greatest benefit may be in > > > improving symptoms of thickened nasal discharge and postnasal > > > drainage.
> > > Am J Rhinol. 2008 Nov-Dec;22(6):560-7.Click here to read Links > > > The efficacy of topical antibiofilm agents in a sheep model of > > > rhinosinusitis. > > > Le T, Psaltis A, Tan LW, Wormald PJ. > > > Department of Surgery-Otolaryngology Head and Neck Surgery, > > > University of Adelaide, Adelaide, Australia. > > > BACKGROUND: Biofilms have been shown to be resistant to > > > conventional antibiotic treatment. This study uses a sheep biofilm > > > model developed by our department to investigate several novel topical > > > anti-biofilm treatments. METHODS: Staphylococcal biofilms were grown > > > in 54 sheep frontal sinuses over 8 days: Each sinus was randomized to > > > (1) no intervention, (2) single mupirocin flush, (3) regular 12-hourly > > > mupirocin flushes for 5 days, (4) Citric Acid Zwitterionic Surfactant > > > (CAZS) via hydrodebrider, (5) gallium nitrate, (6) CAZS with gallium > > > nitrate, (7) CAZS with mupirocin, and (8) saline regular flushes. > > > Sheep were sacrificed and the sinus mucosa harvested 1 or 8 days after > > > treatment to assess treatment and any biofilm regrowth. Confocal > > > scanning laser microscopy was used to confirm the presence or absence > > > of biofilms, and the extent of biofilm reduction was quantitated using > > > fluorescent in situ hybridization and colony forming unit counts. > > > RESULTS: In the control sheep biofilm coverage averaged 31.7%. Saline > > > and mupirocin b.d. washes for 5 days had 23% and 0.84% coverage, > > > respectively, when harvested on day 8. A single mupirocin and gallium > > > wash had 7.7% and 16.2% on day 1 and 5.88% and 16.0% on day 8. CAZS > > > with hydrodebrider had 6.66% on day 1 but 21.95% on day 8 whereas CAZS > > > with hydodebrider and gallium had 13.3% on day 8. CONCLUSION: This > > > study shows that regular treatment with mupirocin produced the most > > > marked reduction in biofilm surface area coverage (0.84% and 1.25%) > > > with sustained effects over the 8-day follow-up period.
> > > On 18 oct, 06:19, potatotree <braecan...@aol.com> wrote: > > >> I saw my ENT doctor this week, he had just gotten back from the annual > > >> meeting of ENT specialists (don't know what they call themselves), and > > >> apparenlty someone presented a study on the role biofilms play in > > >> chronic sinusitis/infections and how to treat them. I know there has > > >> been a lot of discussion on biofilms here, so I'm glad to see it had > > >> hit the mainstream ENT community.
> > >> Anyway, the recommended treatment is irrigating the sinuses with a > > >> solution of warm water and Johnson's baby shampoo. Proportions are > > >> 100:1, water to shampoo. His recommendation is 1/2 tsp in a 250 ml > > >> nasal squirt bottle, the McNeil kind you buy in CVS, Wal-Mart, etc.
> > >> I've done it twice so far, and to be honest, it was most unpleasant > > >> squirting soapy water up my nose. (I added 1/2 tsp. of salt, which > > >> helped.) But no antibiotics seem to be able to eradicate my > > >> pseudomonas, so I'mm going to bite the bullet and do it once a day.
> > >> Wish I could give you the study citation, but I don't have it. But > > >> baby shampoo is what they used.- Hide quoted text -
> > - Show quoted text -
> The baby shampoo irrigation seems to work best for people who have > congestion or a discharge in their sinuses, from what I understand. I > emailed one of the researchers on the baby shampoo study and he > confirmed that it only worked to prevent the formation of biofilms. > Not effective for existing biofilms. As for other biofilm disruptors, > well, there's plenty of them, he said, but they cause collateral > damage. I can attest to that, Lukewarm black tea mixed with saline > wiped out my pseudomas symptoms, st least temporarily, but it > completely plugged up my nose for two weeks.
Could you please say what pseudomonas symptoms the black tea 'wiped out st (sic) least temporarily' and how long was 'temporarily.'
"it completely plugged up my nose for two weeks." Do you know if the 'plugging up' was caused by swelling of the mucosal lining or by the release of solidified mucous from the sinus's that had formed into plugs of congealed mucous into a jelly or semi-solid rubber like substance that began to swell as it's structure was partially broken up and then subsequently hydrated?
Fourteen days, to me, seems to me to be a long time for either -- I have certainly had the experience that use of the tea wash can cause release and subsequent swelling of mucous layers as they pass out but for no longer than 36 hours, usually for me the discomfort is over in 24 hours when accumulated material swells after partial detachment and begins its passage out -- in my case mainly down the throat.
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