Acute sinusitis in children: Do antibiotics have any role?

摘要: Summary Bacteria can be recovered from paranasal sinuses in the majority of patients given diagnosis acute bacterial sinusitis (ABS), and bacteriologic cure achieved with appropriate antibiotic treatment. The critical question is whether correlates meaningful clinical endpoints such as improvement, reduction recurrent disease, or prevention complications. Of 4 pediatric placebo-controlled randomized trials (PCRCTs), 2 suggest superiority treatment lack superiority. PCRCTs adults are mixed to benefit. Pediatric adult meta-analyses demonstrate modest benefit therapy rates spontaneous recovery without antibiotics 60–65%. Although retrospective studies indicate that some who develop orbital neurologic complications were pre-treated therapy, a low rate precludes determination prevents proportion patients. Like literature evidence, expert guideline recommendations mixed. evidence base incomplete conflicting, limited data probably do have role ABS. most compelling rationale serious complications, but proof for this lacking.