The Effects of Long-term Topical Intranasal Steroid Use on Nasal Bacterial Flora

Objective: Administration of intranasal steroids is considered an established first-line therapy for adults with allergic rhinitis. The aim of this study was to evaluate the effects of long-term topical intranasal steroid use on nasal bacterial flora. Methods: This study includes 54 patients (21 male, 33 female) with allergic rhinitis who received topical intanasal steroid once daily to each nares with two puff for a period of three months. Right and left middle meatus cultures were taken before and at the end of third months of intranasal steroid treatment. Results: Two hundred forty nine aerop bacteria were isolated before the treatment and 256 aerop bacteria were isolated after the treatment from the cultures. No bacteria was isolated in 4(3.7%), from the cultures which were taken before the treatment and 3 (2.7%) of the cultures after of treatment. The most common isolated aerobic bacteria in each group were Coagulase-negative staphylococci, Diphtheroid spp. and Streptococcus pneumoniae. Different bacteria were determined from the unilateral middle meatus in the 13(24%) of 54 patients with allergic rhinitis, after the intranasal steroid treatment. Different bacteria from before the treatment such as S aureus (4/13), Difteroid spp (4/13), S pneumoniae (2/13), Streptococcus spp. (2/13) and Klepsiella spp. (2/13) were isolated in cultures which were taken after the treatment. Conclusions: Although different colonization of pathogens in nasal flora after the treatment, symptoms and findings about secondary infections due to flora alteration were not observed in none of our patients. Intranasal steroid using may partially alter the nasal microbial flora but do not increase host susceptibility to a clinical infection.