Related Experiment Video
Updated: Mar 3, 2026
Acupoint Catgut Embedding Therapy in Traditional Chinese Medicine for Managing Allergic Rhinitis
Published on: December 20, 2024
Recurrent Acute Rhinosinusitis Prevention by Azithromycin in Children with Nonallergic Rhinitis
Jittima Veskitkul1, Patcharaporn Wongkaewpothong1, Tanita Thaweethamchareon2
1Faculty of Medicine, Department of Pediatrics, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Insights
Azithromycin prophylaxis significantly reduced recurrent acute rhinosinusitis (RARS) episodes in children with nonallergic rhinitis (NAR). This treatment improved nasal symptoms and decreased medication use over 12 months.
Area of Science:
- Pediatric Otolaryngology
- Clinical Immunology
- Pharmacology
Background:
- Recurrent acute rhinosinusitis (RARS) involves multiple, distinct episodes of acute rhinosinusitis with complete symptom resolution between occurrences.
- The efficacy of antibiotic prophylaxis for preventing RARS in children with nonallergic rhinitis (NAR) remains under-investigated.
Purpose of the Study:
- To investigate the preventive effect of azithromycin on RARS in pediatric patients diagnosed with NAR.
Main Methods:
- A randomized, double-blind, placebo-controlled trial was conducted involving children aged 5-15 years with RARS and NAR.
- Participants received either azithromycin (5 mg/kg/d, 3 days/week for 12 months) or a placebo.
- Outcomes measured included the number of rhinosinusitis episodes, nasal symptom severity via visual analog scale, and adjunctive medication use over 12 months.
Main Results:
- The azithromycin group showed a significant reduction in annual rhinosinusitis episodes from 5 to 0.5 (P < .001), compared to the placebo group.
- The number needed to treat with azithromycin to prevent one case of RARS was 2.
- Significant improvements were observed in nasal symptom scores (2.2 ± 1.4 vs 5.4 ± 1.8) and medication scores (3.9 ± 1.7 vs 5.4 ± 1.1) in the azithromycin group compared to baseline (P < .001).
Conclusions:
- Azithromycin prophylaxis is effective in reducing the frequency of rhinosinusitis episodes in children with NAR and RARS.
- The treatment also led to a significant decrease in medication requirements and an improvement in nasal symptoms.
Background:
Recurrent acute rhinosinusitis (RARS) is characterized by multiple episodes of acute rhinosinusitis between which symptoms and signs resolve completely. The role of antibiotic prophylaxis to prevent RARS in children with nonallergic rhinitis (NAR) has not been investigated.
Objective:
To evaluate the effect of azithromycin to prevent RARS in children with NAR.
Methods:
A randomized, double-blind, placebo-controlled study was conducted in NAR children (5-15 years) with RARS. Azithromycin (5 mg/kg/d) 3 d/wk for 12 months or placebo was assigned to the study group and the control group, respectively. Patients with allergic rhinitis were excluded. Number of rhinosinusitis episodes in 12 months, visual analog scale score of nasal symptoms, and adjunctive medication score were recorded.
Results:
Forty patients were enrolled and 20 patients were assigned randomly to the azithromycin and placebo groups. IgG subclass and specific antibody deficiencies were found in 83% and 2.5% of patients, respectively. After 12 months, the number of rhinosinusitis episodes/y in the azithromycin group reduced significantly from 5 to 0.5 (P < .001) in contrast to the placebo group. Number needed to treat using azithromycin prophylaxis to prevent 1 patient from having RARS was 2. The average visual analog scale score and the average adjunctive medication score in the azithromycin (but not in the placebo) group reduced significantly compared with baseline (2.2 ± 1.4 vs 5.4 ± 1.8) and (3.9 ± 1.7 vs 5.4 ± 1.1), respectively (P < .001).
Conclusions:
Azithromycin prophylaxis can reduce the number of rhinosinusitis episodes and medication score, and improve nasal symptoms in NAR children with RARS.
More Related Videos
06:34A Component-resolved Diagnostic Approach for a Study on Grass Pollen Allergens in Chinese Southerners with Allergic Rhinitis and/or Asthma
Published on: June 4, 2017
16:56Sublingual Immunotherapy as an Alternative to Induce Protection Against Acute Respiratory Infections
Published on: August 30, 2014
Related Concept Videos
01:26Tonsillitis II: Management
01:16Drugs Used in Upper Respiratory Disorders: Overview
Antihistamines (e.g., Benadryl) block histamines from binding. Histamines are chemicals released during an allergic reaction in the body. As a...
01:19Antiasthma Drugs: Leukotriene Modifiers
Leukotriene modifiers work through two distinct mechanisms:
01:23Chronic Pharyngitis
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
01:30Acute Pharyngitis
Acute pharyngitis is the inflammation of the back of the throat (pharynx), commonly resulting in a sore throat. It is a frequently encountered condition that prompts individuals to seek medical advice.
Classification
Acute pharyngitis can be categorized based on its underlying cause:
01:25Antiasthma Drugs: Mast Cell Stabilizers and Anti-IgE Drugs
Mast cell stabilizers, such as cromolyn (also known as sodium cromoglycate) and nedocromil (Tilade), are effective drugs in asthma management. These stabilizers hinder histamine release by skillfully obstructing the activation of mast cells and other cellular entities. Notably, they navigate this task without...