Antibiotic treatment alone for acute rhinosinusitis gives a poor response in allergic children

Area of Science:

• Pediatrics
• Otolaryngology
• Allergy and Immunology

Background:

• Acute rhinosinusitis (ARS) is a common childhood illness.
• Allergic rhinitis can exacerbate paranasal sinus dysfunction during viral infections.

Purpose of the Study:

• To evaluate the efficacy of antibiotic monotherapy for treating ARS in both allergic and non-allergic children.
• To compare symptom resolution and endoscopic sign clearance between allergic and non-allergic pediatric ARS patients receiving antibiotics.

Main Methods:

• A cohort of 97 children (4-9 years) with ARS received amoxicillin-clavulanate for 14 days.
• Clinical symptoms and endoscopic sinus evaluations were performed pre- and post-treatment.
• Statistical analysis included p-values, odds ratios (OR), and Kappa agreement for symptom-endoscopic sign correlation.

Main Results:

• Significant symptom improvement (p<0.001) was observed in 84 patients, irrespective of allergic status.
• Endoscopic signs resolved in only 49 children, with significantly fewer resolutions in allergic children (OR 14.9, p<0.001).
• A slight to fair agreement (Kappa=0.28) was found between clinical symptoms and endoscopic findings.

Conclusions:

• Antibiotic therapy alone is often insufficient for complete ARS resolution, especially for endoscopic signs.
• Allergic children with ARS appear to experience more persistent endoscopic signs despite antibiotic treatment.
• The findings suggest a need for adjunctive therapies beyond antibiotics for managing pediatric ARS, particularly in allergic individuals.