Types of Nasal Rinses
posted on January 12, 2011
The process of actually rinsing out the nasal and sinus passages is probably more important that what you rinse with. The following options are available.
saline recipe.
Antibacterial irrigations
Wilson’s solution, a combination of Gentamycin or Tobramycin and normal saline solution, is the classic antibiotic irrigation.
160mg Gentamycin in 1 L of NS is the standard solution. Bactroban ointment is a water soluble substance, which can be readily dissolved in saline. Typically we use 22 grams of 2% ointment in one liter of normal saline (1 1/2 to 2 inches of ointment in a neilmed rinse kit) and have patients irrigate for four to six weeks as needed. Any ear drop or eye drop is safe to use, and we often use them perioperatively. However, they cost-prohibitive.
Antifungal irrigations
The Mayo Clinic has popularized using
Amphotericin B 100-250 micrograms/ml of sterile wateras an irrigation solution. The stability and efficacy have been questioned, but it seems promising. A reasonable option would be to place 2 50 mg IV vials of Ampho B in 1 liter of distilled water and irrigate each nostril with 20 cc of solution twice a day. Itraconazole (Sporanox), Lamisil, or Diflucan can also be made into a nasal rinse. The Amphotericin nasal rinse needs to be refrigerated, is in sterile water, and has been reported to be difficult to tolerate by many patients. Lamisil and Sporanox are both very expensive.