Ib. Barlan et al., INTRANASAL BUDESONIDE SPRAY AS AN ADJUNCT TO ORAL ANTIBIOTIC-THERAPY FOR ACUTE SINUSITIS IN CHILDREN, Annals of allergy, asthma, & immunology, 78(6), 1997, pp. 598-601
Background: The role of topical corticosteroids in the treatment of ac
ute sinusitis has not been established in children. Objective: An atte
mpt was made to determine the impact of topical corticosteroids as an
adjunct to antibiotic treatment in the management of childhood sinusit
is. Methods: In a double-blind, placebo-controlled study. 151 children
with sinusitis were recruited from a general pediatric outpatient cli
nic and 89 completed a 3-week trial. Treatment consisted of amoxicilli
n-clavulanate potassium, 40 mg/kg/d tid. combined with bid nasal spray
of either budesonide, 50 mu g, to each nostril (n = 43) or placebo in
= 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 s
econd week of budesonide treatment (P < .001) in contrast to continuou
s decline during the second and third weeks in the placebo group (P <
.001 and P < .05, respectively). While the nasal discharge score decre
ased 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 cor
ticosteroids may be a useful ancillary treatment to antibiotics in chi
ldhood sinusitis and effective in reducing the cough and nasal dischar
ge earlier in the course of acute sinusitis.