In February 2020, the European Rhinologic Society published updated guidelines for the treatment of acute and chronic sinusitis and nasal polyps (European Position Paper on Rhinоsinusitis and Nasal Polyps - EPOS 2020) in different patient categories: children, adults, patients with concomitant diseases

Download the full original version of EPOS 2020

The aim of EPOS 2020 is to provide up-to-date, evidence-based recommendations for the management of patients with acute (ARS) and chronic (CRS) rhinosinusitis. Unlike previous guidelines, EPOS 2020 is designed not only for physicians but also for pharmacists, patients, and nursing and caregivers. The document presents a comprehensive framework for the management of patients with ARS and CRS, covering three levels: responsible self-care, primary care, secondary care, and specialist care.

The editorial team of Bacteriophages.info plans to translate key algorithms and recommendations for the EPOS 2020 document into Ukrainian: follow the publications on the website and the Bacteriophages Facebook page.

The EPOS 2020 guidelines provide clear clinical definitions:

- acute rhinosinusitis (ARS) - inflammation of the nose and paranasal sinuses with a duration of symptoms of less than 12 weeks, which is a consequence of an acute respiratory viral infection or a common cold;

- recurrent (recurrent) ARS - recurrence of ARS four or more times a year after periods of complete absence of symptoms;

- chronic rhinosinusitis (CRS) - inflammation of the nose and paranasal sinuses with symptoms lasting more than 12 weeks without complete regression.

EPOS 2020 also identifies three clinical forms of ARS, which constitute three successive stages of the development of the pathological process in ARS:

- acute viral rhinosinusitis, or the common cold, in which the duration of symptoms does not exceed 10 days;

- acute post-viral rhinosinusitis, which is characterized by an increase in the severity of symptoms after 5 days or their persistence for more than 10 days with a duration of less than 12 weeks;

- acute bacterial rhinosinusitis, which is caused by a bacterial infection and lasts up to 12 weeks.

A new classification of CRS into primary and secondary, followed by a division into localized and diffuse, is also presented.

The section on acute respiratory syndrome (ARS) and chronic respiratory syndrome (CRS) in children has been completely revised.

Taking into account all available evidence, algorithms for the management of ARS and HRS with or without nasal polyps in adults and children are proposed.

EPOS 2020 specifically emphasizes the importance of preventing the unnecessary use of antibiotics in the treatment of rhinosinusitis, which is particularly relevant today given the spread of antibiotic resistance. Among the agents that could serve as alternatives to antibiotics in the treatment of chronic bacterial sinusitis, the EPOS 2020 document points to bacteriophages, which are capable of killing multidrug-resistant bacteria and preventing biofilm formation.

Download the full original version of EPOS 2020