Acute sinusitis in children - results of different therapeutic regimens

The clinical material consisted of 92 children aged 1-15 years with symptoms and signs of acute sinusitis, roentgenologically verified. Sixty-one were treated with penicillin-V, 16 with pivampicillin, and 15 with erythromycin. Decongesting therapy was given to all. Altogether 77 (83.7%) were cured by a single 10-day course of treatment. The initial success rate did not vary with the type of antibiotic used. Children treated with penicillin-V had, however, a high relapse rate with H. influenzae. Because of growth of H. influenzae, 15 patients required 2 or 3 courses of treatment. The study shows that acute sinusitis in children is usually an uncomplicated disease. Almost all children will improve during a single 10-day course of treatment with antibiotics and decongestants provided that the antibiotic chosen is one to which H. influenzae is susceptible. It is therefore stressed that if penicillin-V is used as the drug of choice in acute sinusitis, the dose must be large enough to eradicate H. influenzae. As judged from this study, adenoidectomy and intranasal antrostomy are rarely indicated.