Updated acute bacterial sinusitis guidelines include four major changes
FROM PEDIATRICS
Five other trials that compared antimicrobial therapies lacked placebo controls, three dealt with subacute sinusitis rather than acute, and six tested various ancillary treatments. These ancillary treatments included steroids, nasal spray, saline irrigation, and mucolytic agents, but with small study populations and mostly equivocal results.
"Greater severity of illness at the time of presentation seems to be associated with increased likelihood of antimicrobial efficacy," Dr. Smith said.
Dr. Smith identified several clinical questions that require additional research: definitions of acute, subacute, and recurrent acute sinusitis; the epidemiology of sinusitis in the pneumococcal conjugate vaccine era; the effectiveness of antimicrobial prophylaxis; accurate estimates for duration of symptoms; and clinical utility of various imaging types.
The guidelines and systematic review did not identify any external funding used. Dr. Smith has received research funding from Sanofi Pasteur and Novartis. Dr. Nelson is employed by McKesson Health Solutions. Dr. Wald, Dr. Shaikh, and Dr. Rosenfeld have published research related to sinusitis. No other disclosures were reported.
