ORIGINAL PAPER
Effect of fusidic acid phonophoresis as a complementary therapy in chronic rhinosinusitis: a randomised clinical trial
1
Department of Orthopedic Physiotherapy, KAHER Institute of Physiotherapy, Belagavi, Karnataka, India
2
Department of Otorhinolaryngology, Jawaharlal Nehru Medical College, Belagavi, Karnataka, India
3
Department of Microbiology, Jawaharlal Nehru Medical College, Belagavi, Karnataka, India
Submission date: 2025-03-21
Acceptance date: 2025-12-11
Online publication date: 2026-06-25
Corresponding author
Vijay Kage
Department of Orthopedic Physiotherapy, KAHER Institute of Physiotherapy, Belagavi 590010, Karnataka, India
Department of Orthopedic Physiotherapy, KAHER Institute of Physiotherapy, Belagavi 590010, Karnataka, India
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Chronic rhinosinusitis (CRS) is a common inflammatory condition that reduces quality of life (QoL). Erythromycin phonophoresis (EMP) has shown therapeutic potential for CRS. While fusidic acid is effective topically for skin infections due to its antibacterial properties, its use in CRS remains unstudied. To compare the efficacy and feasibility of fusidic acid phonophoresis (FAP) and EMP in CRS based on QoL, pain pressure threshold (PPT) and bacterial reduction.
Methods:
A randomised clinical study with 32 CRS participants (mean age: experimental 39.5 ± 13.0, control 45.4 ± 9.2 years) compared FAP (experimental n = 16) and EMP (control n = 16) interventions, delivered thrice weekly for 10 sessions. Participants and assessors were blinded, and group allocation was performed using the envelope method. Outcomes included the Sino-Nasal Outcome Test-22 (SNOT-22) for QoL, PPT via pressure algometer and bacterial colony counts, assessed pre- and post-intervention. Feasibility was evaluated based on economic factors, ease of implementation, clinical impact, and potential adverse events.
Results:
Normality and variance homogeneity were checked using Shapiro–Wilk and Levene’s tests. Independent and dependent t-tests (p < 0.05) showed significant within-group improvements in FAP (SNOT-22: 23.4 ± 15.0; effect size: 0.72, PPT: −0.49 ± 0.31; effect size: 0.73) and EMP (SNOT-22: 19.19 ± 13.61; effect size: 0.67, PPT: −0.48 ± 0.24; effect size: 0.80) at p < 0.01. Between-group differences were nonsignificant (SNOT-22: p = 0.40, CI: −6.10 to 14.60; PPT: p = 0.89, CI: −0.19 to 0.21), showing no clinical superiority.
Conclusions:
FAP is a feasible and effective alternative to EMP in terms of safety, reduced bacterial growth and tenderness with improved QoL in individuals with CRS.
Chronic rhinosinusitis (CRS) is a common inflammatory condition that reduces quality of life (QoL). Erythromycin phonophoresis (EMP) has shown therapeutic potential for CRS. While fusidic acid is effective topically for skin infections due to its antibacterial properties, its use in CRS remains unstudied. To compare the efficacy and feasibility of fusidic acid phonophoresis (FAP) and EMP in CRS based on QoL, pain pressure threshold (PPT) and bacterial reduction.
Methods:
A randomised clinical study with 32 CRS participants (mean age: experimental 39.5 ± 13.0, control 45.4 ± 9.2 years) compared FAP (experimental n = 16) and EMP (control n = 16) interventions, delivered thrice weekly for 10 sessions. Participants and assessors were blinded, and group allocation was performed using the envelope method. Outcomes included the Sino-Nasal Outcome Test-22 (SNOT-22) for QoL, PPT via pressure algometer and bacterial colony counts, assessed pre- and post-intervention. Feasibility was evaluated based on economic factors, ease of implementation, clinical impact, and potential adverse events.
Results:
Normality and variance homogeneity were checked using Shapiro–Wilk and Levene’s tests. Independent and dependent t-tests (p < 0.05) showed significant within-group improvements in FAP (SNOT-22: 23.4 ± 15.0; effect size: 0.72, PPT: −0.49 ± 0.31; effect size: 0.73) and EMP (SNOT-22: 19.19 ± 13.61; effect size: 0.67, PPT: −0.48 ± 0.24; effect size: 0.80) at p < 0.01. Between-group differences were nonsignificant (SNOT-22: p = 0.40, CI: −6.10 to 14.60; PPT: p = 0.89, CI: −0.19 to 0.21), showing no clinical superiority.
Conclusions:
FAP is a feasible and effective alternative to EMP in terms of safety, reduced bacterial growth and tenderness with improved QoL in individuals with CRS.
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