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Management of acute rhinosinusitis
Francesca Mori1, Alessandro Fiocchi, Simona Barni
1Allergy Unit, A. Meyer Children's Hospital, Department of Pediatrics, University of Florence, Viale Pieraccini 24, Florence, Italy.
Summary
Acute rhinosinusitis (ARS), a common condition, is often caused by bacterial superinfections after viral illnesses. Diagnosis relies on clinical symptoms, and while most cases resolve spontaneously, topical steroids show some efficacy in treatment.
Area of Science:
- Otolaryngology
- Pediatrics
- Infectious Diseases
Background:
- Acute rhinosinusitis (ARS) is a frequent cause of medical visits and school absenteeism.
- Precise epidemiological data on ARS prevalence and incidence remain limited.
- Bacterial superinfection following viral respiratory infections is the primary mechanism of ARS.
Purpose of the Study:
- To review the diagnosis and management of acute rhinosinusitis in pediatric populations.
- To evaluate the evidence for various topical treatments used in pediatric ARS.
- To highlight the challenges in diagnosing and managing ARS.
Main Methods:
- Clinical diagnosis of ARS is based solely on presenting symptoms.
- Literature review of topical treatments for pediatric ARS.
- Analysis of the typical course and resolution of acute bacterial rhinosinusitis.
Main Results:
- Acute bacterial rhinosinusitis is generally self-limiting, with spontaneous recovery within four weeks.
- Evidence supporting the efficacy of most topical treatments (saline irrigation, decongestants, antihistamines, fungicides) is weak.
- Topical steroids demonstrate some evidence of efficacy in managing pediatric ARS.
Conclusions:
- Accurate clinical diagnosis of ARS is crucial for appropriate management decisions.
- Identifying bacterial superinfections is key to initiating antibiotic therapy when necessary.
- ARS presents a complex diagnostic and therapeutic challenge for healthcare providers.
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