A Phase 4 interventional study of Amoxi Clavulanate in Chronic Sinus Infection, sponsored by Montefiore Medical Center. Terminated at 1 site in United States. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2025-06-17.
Sponsored by Montefiore Medical Center · Phase 4, Interventional, and Prevention
The objective of this study is to determine whether the use of postoperative antibiotics following endoscopic sinus surgery (ESS) decreases postoperative infection rates. This is a multi-institutional prospective study involving Albert Einstein College of Medicine/Montefiore Medical Center, Columbia University Medical Center, Weill Cornell Medical College, Mount Sinai Health System, and New York University Langone Medical Center. The study design will be a multi-institutional prospective randomized controlled trial with parallel random groups assigned to receive postoperative antibiotics or no postoperative antibiotics. The investigators hypothesize that patients who receive postoperative antibiotics will have lower postoperative infection rates and improved postoperative sinonasal symptoms and nasal endoscopy scores.
Exclusion Criteria:
To receive postoperative antibiotics
Drug: Amoxi Clavulanate
Will not receive any postoperative antibiotics
Postoperative antibiotics
Postoperative Infection
The number/percentage of participants with postoperative infection rate, as assessed by rigid nasal endoscopy in the office and culture of suspected infectious material noted within the paranasal sinuses will be reported. A postoperative infection as defined by having an infection at ANY of the postoperative visits AND detected initially by evidence of purulence on nasal endoscopy will be considered an infection if the culture swab from the site of purulence during that office visit confirms that there is an actual bacterial source of the infection.
Time frame: During all three scheduled postoperative visits: 7-10 days postoperatively; 2-4 weeks postoperatively; 6-8 weeks postoperatively
Postoperative Sino-nasal Outcome Test (SNOT-22) Scores
Postoperative SNOT-22 scores will be summarized for each visit based on patient-reported symptoms. The SNOT-22 is a 22-item questionnaire used to assess the impact of chronic rhinosinusitis (CRS) on a patient's health-related quality of life. Participants are presented with a list of symptoms and social/emotional consequences of rhinosinusitis and asked to rate each problem over the prior 2-week period on a 6-point Likert scale ranging from 0 ("No Problem") to 5 ("Problem as bad as it can be)" yielding an overall possible scoring range of 0-110. Higher scores are indicative of a greater burden CRS-related symptoms. Scores are summarized by study arm using basic descriptive statistics.
Time frame: During all three scheduled postoperative visits: 7-10 days postoperatively; 2-4 weeks postoperatively; 6-8 weeks postoperatively
Perioperative Sinus Endoscopy (POSE) Scores
Sinonasal crusting and inflammation was determined using the perioperative sinus endoscopy (POSE) scoring system based on patient-reported symptoms obtained during all three study visits. POSE assigns points to various areas within the nasal passages, based on the presence of certain conditions like crusting, edema, polyps, secretions, etc. For purposes of this study each parameter was scored from 0-2 yielding an overall possible score of 0-10, with higher scores being indicative of more extensive disease severity or surgical extent in the sinuses. Scores are summarized by study arm using basic descriptive statistics.
Time frame: During all three scheduled postoperative visits: 7-10 days postoperatively; 2-4 weeks postoperatively; 6-8 weeks postoperatively
| Milestone | Antibiotics | No Antibiotics |
|---|---|---|
| Started | 12 | 12 |
| Completed | 2 | 4 |
| Not completed | 10 | 8 |
The number/percentage of participants with postoperative infection rate, as assessed by rigid nasal endoscopy in the office and culture of suspected infectious material noted within the paranasal sinuses will be reported. A postoperative infection as defined by having an infection at ANY of the postoperative visits AND detected initially by evidence of purulence on nasal endoscopy will be considered an infection if the culture swab from the site of purulence during that office visit confirms that there is an actual bacterial source of the infection.
| Participants | Antibiotics | No Antibiotics |
|---|---|---|
| Postoperative Infection | 1 | 0 |
Postoperative SNOT-22 scores will be summarized for each visit based on patient-reported symptoms. The SNOT-22 is a 22-item questionnaire used to assess the impact of chronic rhinosinusitis (CRS) on a patient's health-related quality of life. Participants are presented with a list of symptoms and social/emotional consequences of rhinosinusitis and asked to rate each problem over the prior 2-week period on a 6-point Likert scale ranging from 0 ("No Problem") to 5 ("Problem as bad as it can be)" yielding an overall possible scoring range of 0-110. Higher scores are indicative of a greater burden CRS-related symptoms. Scores are summarized by study arm using basic descriptive statistics.
| score on a scale | Antibiotics | No Antibiotics |
|---|---|---|
| 7 to 10 days post op | 25 ± 2 | 22 ± 1 |
| 2 to 4 weeks post op | 23 ± 1.5 | 21 ± 0.5 |
| 6 to 8 weeks post op | 22 ± 0.5 | 21 ± 0.5 |
Sinonasal crusting and inflammation was determined using the perioperative sinus endoscopy (POSE) scoring system based on patient-reported symptoms obtained during all three study visits. POSE assigns points to various areas within the nasal passages, based on the presence of certain conditions like crusting, edema, polyps, secretions, etc. For purposes of this study each parameter was scored from 0-2 yielding an overall possible score of 0-10, with higher scores being indicative of more extensive disease severity or surgical extent in the sinuses. Scores are summarized by study arm using basic descriptive statistics.
| score on a scale | Antibiotics | No Antibiotics |
|---|---|---|
| 7 to 10 days post op | 5.4 ± 1.4 | 5.2 ± 1.1 |
| 2 to 4 weeks post op | 4.3 ± 0.6 | 4.1 ± 0.8 |
| 6 to 8 weeks post op | 3.8 ± 0.2 | 3.5 ± 0.4 |
Collected over Up to 8 weeks following endoscopic sinus surgery. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Antibiotics | 0/12 (0%) | 0/12 (0%) | 0/12 (0%) |
| No Antibiotics | 0/12 (0%) | 0/12 (0%) | 0/12 (0%) |
| Age, Categorical(Participants) | Antibiotics | No Antibiotics | Total |
|---|---|---|---|
| <=18 years | 0 | 0 | 0 |
| Between 18 and 65 years | 10 | 8 | 18 |
| >=65 years | 2 | 4 | 6 |
| Age, Continuous(Years) | Antibiotics | No Antibiotics | Total |
|---|---|---|---|
| Mean | 52 (25 to 71) | 46 (22 to 74) | 49 (22 to 71) |
| Sex: Female, Male(Participants) | Antibiotics | No Antibiotics | Total |
|---|---|---|---|
| Female | 5 | 8 | 13 |
| Male | 7 | 4 | 11 |
| Region of Enrollment(participants) | Antibiotics | No Antibiotics | Total |
|---|---|---|---|
| United States | 12 | 12 | 24 |
| Race (NIH/OMB)(Participants) | Antibiotics | No Antibiotics | Total |
|---|---|---|---|
| American Indian or Alaska Native | 0 | 0 | 0 |
| Asian | 1 | 2 | 3 |
| Native Hawaiian or Other Pacific Islander | 0 | 0 | 0 |
| Black or African American | 4 | 5 | 9 |
| White | 7 | 4 | 11 |
| More than one race | 0 | 0 | 0 |
| Unknown or Not Reported | 0 | 1 | 1 |
| Active Infection at time of surgery(Participants) | Antibiotics | No Antibiotics | Total |
|---|---|---|---|
| Count of participants | 12 | 12 | 24 |
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Montefiore Medical Center