BACKGROUND: The role of topical corticosteroids in the treatment of acute sinusitis has not been established in children. OBJECTIVE: An attempt was made to determine the impact of topical corticosteroids as an adjunct to antibiotic treatment in the management of childhood sinusitis. METHODS: In a double-blind, placebo-controlled study, 151 children with sinusitis were recruited from a general pediatric outpatient clinic and 89 completed a 3-week trial. Treatment consisted of amoxicillin-clavulanate potassium, 40 mg/kg/d tid, combined with bid nasal spray of either budesonide, 50 micrograms, to each nostril (n = 43) or placebo )n = 46_ for 3 weeks. Patients maintained daily symptom cards throughout the study and were examined by the same physician each week. RESULTS:Clinical symptoms and signs decreased significantly in both treatment groups in comparison to baseline (P < .01). We detected a significant improvement in the scores of the cough and nasal discharge at the end of second week in the budesonide group when compared with placebo (P < .05). Friedman nonparametric repeated measures ANOVA test revealed a significant decrease in the total weekly scores of cough during the second week of budesonide treatment (P < .001) in contrast to continuous decline during the second and third weeks in the placebo group (P < .001 and P < .05, respectively). While the nasal discharge score decreased significantly during the second week in the budesonide group (P < .01), no significant effect on the nasal discharge score was observed in the placebo group. CONCLUSION: These data suggest that topical corticosteroids may be a useful ancillary treatment to antibiotics in childhood sinusitis and effective in reducing the cough and nasal discharge earlier in the course of acute sinusitis.
RCT Entities:
BACKGROUND: The role of topical corticosteroids in the treatment of acute sinusitis has not been established in children. OBJECTIVE: An attempt was made to determine the impact of topical corticosteroids as an adjunct to antibiotic treatment in the management of childhood sinusitis. METHODS: In a double-blind, placebo-controlled study, 151 children with sinusitis were recruited from a general pediatric outpatient clinic and 89 completed a 3-week trial. Treatment consisted of amoxicillin-clavulanate potassium, 40 mg/kg/d tid, combined with bid nasal spray of either budesonide, 50 micrograms, to each nostril (n = 43) or placebo )n = 46_ for 3 weeks. Patients maintained daily symptom cards throughout the study and were examined by the same physician each week. RESULTS: Clinical symptoms and signs decreased significantly in both treatment groups in comparison to baseline (P < .01). We detected a significant improvement in the scores of the cough and nasal discharge at the end of second week in the budesonide group when compared with placebo (P < .05). Friedman nonparametric repeated measures ANOVA test revealed a significant decrease in the total weekly scores of cough during the second week of budesonide treatment (P < .001) in contrast to continuous decline during the second and third weeks in the placebo group (P < .001 and P < .05, respectively). While the nasal discharge score decreased significantly during the second week in the budesonide group (P < .01), no significant effect on the nasal discharge score was observed in the placebo group. CONCLUSION: These data suggest that topical corticosteroids may be a useful ancillary treatment to antibiotics in childhood sinusitis and effective in reducing the cough and nasal discharge earlier in the course of acute sinusitis.
Authors: Paul K Keith; Andrzej Dymek; Oliver Pfaar; Wytske Fokkens; Suyong Yun Kirby; Wei Wu; Cindy Garris; Nazli Topors; Laurie A Lee Journal: Prim Care Respir J Date: 2012-09
Authors: Martin Desrosiers; Gerald A Evans; Paul K Keith; Erin D Wright; Alan Kaplan; Jacques Bouchard; Anthony Ciavarella; Patrick W Doyle; Amin R Javer; Eric S Leith; Atreyi Mukherji; R Robert Schellenberg; Peter Small; Ian J Witterick Journal: Allergy Asthma Clin Immunol Date: 2011-02-10 Impact factor: 3.406
Authors: Cindy M Liu; Michael A Kohanski; Michelle Mendiola; Katerina Soldanova; Michael G Dwan; Richard Lester; Lora Nordstrom; Lance B Price; Andrew P Lane Journal: Int Forum Allergy Rhinol Date: 2014-12-29 Impact factor: 3.858