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Systemic treatment of rhinosinusitis in children

E Novembre1, F Mori, N Pucci

  • 1Allergy and Clinical Immunology Unit, Anna Meyer Children's Hospital, Department of Pediatrics, University of Florence, Italy. e.novembre@meyer.it

Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology
|January 19, 2008
PubMed

Insights

Antibiotic therapy is key for acute rhinosinusitis, with amoxicillin as the primary choice. Chronic rhinosinusitis treatment lacks consensus, though systemic steroids may reduce inflammation.

Area of Science:

  • Otolaryngology
  • Infectious Diseases
  • Pharmacology

Background:

  • Bacterial pathogens are central to acute rhinosinusitis, necessitating antibiotic interventions.
  • Chronic rhinosinusitis presents variable bacteriology, complicating antimicrobial treatment strategies and consensus.
  • Adjuvant therapies require further validation through rigorous studies.

Purpose of the Study:

  • To review current therapeutic approaches for acute and chronic rhinosinusitis.
  • To outline antibiotic choices and considerations for different rhinosinusitis types.
  • To discuss the role and evidence for adjuvant therapies in rhinosinusitis management.

Main Methods:

  • Literature review of systemic therapies for acute and chronic rhinosinusitis.
  • Analysis of antibiotic efficacy and resistance patterns.
  • Evaluation of evidence for adjuvant treatments like steroids, antihistamines, and leukotriene modifiers.

Main Results:

  • Amoxicillin is the preferred antibiotic for acute rhinosinusitis; alternatives exist for allergies or anaerobic infections.
  • No established consensus on chronic rhinosinusitis antimicrobial treatment duration or specific agents due to polymicrobial nature.
  • Short systemic steroid courses show promise for reducing mucosal inflammation in chronic rhinosinusitis, but require pediatric validation.

Conclusions:

  • Antibiotic selection for acute rhinosinusitis is guided by pathogen prevalence and patient factors.
  • Chronic rhinosinusitis management is complex, requiring individualized approaches based on causative factors.
  • Evidence supporting antihistamines, decongestants, and leukotriene modifiers in rhinosinusitis is currently limited.

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