Treatment of Children with Sinusitis

Treatment of Children with Sinusitis

Sinusitis in children with respiratory symptoms is uncommon, but, for those who have sinusitis, antibiotics improve clinical outcomes.

The effectiveness of antibiotics in children with sinusitis is uncertain. In a randomized, double-blind trial, 56 children (age range, 1–10 years) with clinical diagnoses of sinusitis received either amoxicillin (90 mg/kg) plus clavulanate potassium (6.4 mg/kg) or placebo for 14 days. Sinusitis was defined as persistent symptoms (nasal discharge, daytime cough) for >10 days, worsening symptoms on or after the sixth day of symptoms, or severe symptoms (temperature $≥$ 102ºF and purulent nasal discharge) for at least 3 consecutive days. Of 2135 children with upper respiratory infection (URI) symptoms who were assessed for eligibility, only 139 (6.5%) met criteria for sinusitis.

Parents were contacted daily, and children were considered cured if their clinical severity score declined by 50%. Children who received antibiotics were significantly more likely to be cured (50% vs. 14%) and less likely to experience treatment failure (14% vs. 68%). Adverse side effects, such as diarrhea, were significantly more common in the antibiotic group (44% vs. 14%).

Comment: Two findings from this study stand out. First, sinusitis in children with URI symptoms is uncommon. Second, antibiotics improve clinical outcomes in children with sinusitis.

— Howard Bauchner, MD

Published in Journal Watch Pediatrics and Adolescent Medicine July 22, 2009

Citation(s):

Wald ER et al. Effectiveness of amoxicillin/clavulanate potassium in the treatment of acute bacterial sinusitis in children. Pediatrics 2009 Jul; 124:9.

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Medline abstract (Free)

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bascterial sinusitis in pediatrics
Phyllis S Salyards, Hastings Family Practice, 23 Jul 2009 11:44 AM EST
Your summary says sinusitis is rare which I agree with ,but their article abstract asserts that "it is a common... [more]

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