Management of clinically diagnosed subacute rhinosinusitis in children under the age of two years: a randomized,...

Area of Science:

• Pediatric Otolaryngology
• Infectious Diseases
• Pharmacology

Background:

• Subacute rhinosinusitis (SRS) in children under two years can manifest as persistent cough, fever, snoring, ear issues, and feeding difficulties.
• Clinical diagnosis is typical for pediatric rhinosinusitis.
• SRS symptoms can significantly impact a child's well-being and development.

Purpose of the Study:

• To evaluate and compare the effectiveness of culture-based antibiotic treatment versus empiric amoxicillin-clavulanate for pediatric SRS.
• To determine the optimal antibiotic strategy for young children diagnosed with SRS.
• To provide evidence-based recommendations for managing SRS in infants and toddlers.

Main Methods:

• A randomized controlled study involving sixty children under two years with SRS symptoms lasting 30-90 days.
• Participants were divided into two groups: one receiving culture-based antibiotics (n=30) and the other empiric amoxicillin-clavulanate (40 mg/kg/day) (n=30).
• Treatment duration was two weeks, with follow-up assessments conducted over three weeks.

Main Results:

• The group treated with culture-based antibiotics showed statistically significant greater improvements in nasal obstruction (p = 0.037).
• Significant improvements in nasal discharge were also observed in the culture-based antibiotic group compared to the empiric group (p = 0.003).
• These findings indicate a superior clinical response with targeted antibiotic therapy.

Conclusions:

• Culture-based antibiotics demonstrated superior efficacy in treating subacute rhinosinusitis in children under two years.
• Empiric amoxicillin-clavulanate (40 mg/kg/day) was less effective than targeted antibiotic therapy.
• The study supports the use of antibiotic susceptibility testing for optimizing SRS treatment outcomes in pediatric patients.