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Antibióticos y esteroides nasales tópicos para el tratamiento de la sinusitis maxilar aguda: un ensayo controlado
Ian G Williamson1, Kate Rumsby, Sarah Benge
1Department of Medicine, University of Southampton, Southampton, England. igw@soton.ac.uk
JAMA
|December 7, 2007
Resumen
Este estudio encontró que ni la amoxicilina (antibiótico) ni la budesonida (esteroide nasal) trataron eficazmente la sinusitis aguda en la atención primaria. La terapia de combinación tampoco mostró un beneficio significativo para la duración de los síntomas de la sinusitis.
Área de la Ciencia:
- La otorrinolaringología otorrinolaringología.
- Medicina de la Atención Primaria Medicina de la Atención Primaria.
- Farmacología clínica Farmacología clínica.
Sus antecedentes:
- La sinusitis aguda es una condición prevalente que a menudo se trata con antibióticos, aunque su eficacia se debate.
- Los esteroides tópicos están poco investigados para la sinusitis aguda a pesar de los potenciales beneficios antiinflamatorios.
Objetivo del estudio:
- Evaluar la eficacia de la amoxicilina y la budesonida tópica en el tratamiento de la sinusitis maxilar aguda.
- Para comparar la monoterapia con antibióticos y esteroides nasales frente a la terapia combinada y el placebo.
Principales métodos:
- Un ensayo factorial doble ciego, aleatorizado y controlado con placebo en el que participaron 240 adultos con sinusitis aguda no recurrente.
- Los pacientes recibieron amoxicilina (500 mg TID durante 7 días) y / o budesonida (200 mcg al día durante 10 días) o placebo.
- La curación clínica se evaluó mediante diarios de síntomas, centrándose en la duración y la gravedad al día 10.
Principales resultados:
- La amoxicilina no redujo significativamente la duración de los síntomas (29% frente al 33,6%).
- La budesonida tópica tampoco mostró ningún efecto significativo en la duración de los síntomas (31,4% frente a 31,4%).
- Los esteroides nasales parecían ser más efectivos en pacientes con síntomas iniciales menos severos.
Conclusiones:
- Ni la amoxicilina ni la budesonida tópica, solos o en combinación, demostraron efectividad para la sinusitis aguda en la atención primaria.
- Los hallazgos sugieren que los regímenes actuales de antibióticos y esteroides tópicos pueden no ser beneficiosos para esta afección en el entorno estudiado.
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