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Predicting response to antimicrobial therapy in children with acute sinusitis
Nader Shaikh1, Ellen R Wald2, Jong H Jeong3
1Division of General Academic Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA.
The Journal of Pediatrics
|December 26, 2013
Summary
In children with acute sinusitis, Streptococcus pneumoniae colonization predicted faster symptom resolution with antimicrobial therapy. This finding may guide future treatment strategies for pediatric respiratory infections.
Area of Science:
- Pediatric Infectious Diseases
- Microbiology
- Clinical Medicine
Background:
- Acute sinusitis is common in children, often treated with antibiotics.
- Predicting response to antimicrobial therapy is crucial for effective management.
- The role of specific nasopharyngeal pathogens in treatment outcomes requires further investigation.
Purpose of the Study:
- To identify independent prognostic factors for antimicrobial therapy response in pediatric acute sinusitis.
- To evaluate the association between baseline clinical factors and symptom resolution time.
Main Methods:
- Prospective study of 206 children with acute sinusitis receiving antimicrobial therapy.
- Symptom severity assessed using a validated scale 8-12 days post-treatment initiation.
- Analysis of univariate and multivariate associations between diagnosis factors and symptom resolution.
Main Results:
- Children with nasopharyngeal Streptococcus pneumoniae colonization showed faster symptom resolution (median 6.5 days vs. 8.5 days).
- Age and radiographic findings did not predict time to symptom resolution.
- Nasopharyngeal culture results were a significant predictor of treatment response.
Conclusions:
- Proven nasopharyngeal Streptococcus pneumoniae colonization independently predicts faster symptom resolution in children with acute sinusitis.
- Testing for nasopharyngeal pathogens may aid in predicting treatment response.
- Further research, including randomized controlled trials, is warranted to confirm these findings.
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