Abstract: OBJECTIVE To explore the pathogenic distribution and drug resistance in nasal lavage fluid（NLF） of children with chronic rhinosinusitis（CRS）, and to analyze the treatment curative effect of drugs combined with surgery. METHODS A total of 108 children with CRS and adenoid hypertrophy admitted to the Otolaryngology Department of Wuhan Children’s Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from Sep 2018 to Jan 2020 were enrolled as the research subjects. They were randomly divided into the observation group and control group, 54 cases in each group. Before the treatment, NLF of all children was collected for pathogens culture identification and drug sensitivity tests. The distribution and drug resistance of NLF pathogens in CRS children were analyzed. The control group was treated with antibiotics, glucocorticoids, nasal irrigation, mucolytics and mucokinetic drugs, while the observation group was treated with adenoidectomy on basis of the treatment in the control group. The scores of visual analogue scale（VAS） of clinical symptoms, nasal endoscopy and sinus CT after 14 days of treatment were compared between the two groups. RESULTS Among the specimens from 108 CRS children, there were 91 cases（84.26%） with positive bacterial culture. Among the 91 specimens, there were 136 strains of pathogens, including 80 strains（58.82%） of Gram-positive bacteria（mainly on Staphylococcus epidermidis, Streptococcus viridans） and 56 strains（41.18%） of Gram-negative bacteria（mainly on Enterobacter aerogenes, Klebsiella pneumoniae）. The drug resistance rates of S. epidermidis were high to penicillin G and erythromycin, but the strain was sensitive to vancomycin. E. aerogenes were resistant to cefazolin, ampicillin and gentamicin, and sensitive to imipenem, cefepime and ceftazidime. After the treatment, scores of VAS, nasal endoscopy and nasal sinus CT in both groups were significantly decreased（P＜0.05）, and those in observation group decreased more significantly（P＜0.05）. CONCLUSION The pathogen in nasal infection in CRS patients is mainly on Gram-positive bacteria. The antimicrobial drugs should be reasonably selected based on pathogenic bacteria distribution and drug resistance tests. The combination of effective antimicrobial drugs and adenoidectomy can further improve curative effect.