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Saline nasal irrigation for acute sinusitis (SNIFS II): a randomised controlled pilot trial with nested process
Roderick P Venekamp1, Ben Ainsworth2, Tammy Thomas3
1Department of General Practice and Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
BJGP Open
|March 31, 2025
Summary
Saline nasal irrigation is an acceptable alternative for adults with acute sinusitis. A pilot study found this intervention feasible, suggesting a larger trial is warranted to confirm its effectiveness.
Area of Science:
- Otolaryngology
- General Practice
- Clinical Trials
Background:
- Antibiotics are frequently prescribed for acute sinusitis despite limited benefits.
- There is a need for alternative treatments for acute sinusitis.
- This study investigates saline nasal irrigation as a potential alternative.
Purpose of the Study:
- To assess the feasibility and acceptability of saline nasal irrigation for acute sinusitis.
- To evaluate recruitment and follow-up rates in a randomized controlled pilot trial.
- To determine adherence and participant acceptance of saline nasal irrigation.
Main Methods:
- A randomized controlled pilot trial with a nested process evaluation was conducted in 24 English general practices.
- Participants received either saline nasal irrigation with delayed antibiotic prescription or usual care.
- Feasibility outcomes included recruitment, follow-up, adherence, and acceptability.
Main Results:
- A 76% consent and randomization rate was achieved (81/107).
- Saline nasal irrigation led to reduced antibiotic prescribing (60% vs 38%).
- Most participants found saline nasal irrigation acceptable and a viable alternative to antibiotics.
Conclusions:
- Saline nasal irrigation is an acceptable intervention for adults with acute sinusitis.
- A pilot trial demonstrated the feasibility of implementing saline nasal irrigation.
- Further large-scale trials are recommended to establish the effectiveness of saline nasal irrigation.
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