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Intranasal budesonide spray as an adjunct to oral antibiotic therapy for acute sinusitis in children.

AbstractBACKGROUND:
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.
AuthorsI B Barlan, E Erkan, M Bakir, S Berrak, M M Başaran
JournalAnnals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology (Ann Allergy Asthma Immunol) Vol. 78 Issue 6 Pg. 598-601 (Jun 1997) ISSN: 1081-1206 [Print] United States
PMID9207726 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)
Chemical References
  • Aerosols
  • Anti-Bacterial Agents
  • Anti-Inflammatory Agents
  • Penicillins
  • Pregnenediones
  • Budesonide
  • Amoxicillin
Topics
  • Acute Disease
  • Adolescent
  • Aerosols
  • Amoxicillin (therapeutic use)
  • Anti-Bacterial Agents (therapeutic use)
  • Anti-Inflammatory Agents (administration & dosage)
  • Budesonide
  • Child
  • Child, Preschool
  • Double-Blind Method
  • Drug Therapy, Combination
  • Female
  • Humans
  • Infant
  • Male
  • Penicillins (therapeutic use)
  • Pregnenediones (administration & dosage)
  • Sinusitis (drug therapy)

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