Review of Systemic Antibiotic Treatments in Children with Rhinosinusitis
Abstract
:1. Introduction
2. Microbiological Basis
3. Aim of Study and Methods
4. Results
5. Discussion
6. Conclusions
Author Contributions
Conflicts of Interest
References
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Author, Year | Pts Category | No. of Pts; Age (Years) | Study Design | Interventions | Outcomes | Failures and Side Effects | |
---|---|---|---|---|---|---|---|
Wald et al., 2009 [2] | 56; 66 ± 30 months | Prospective randomised | Amoxicillin (90 mg/kg/day) with potassium clavulanate (6.4 mg/kg/day) in two doses (50%) vs. placebo | Children receiving antibiotics were more likely to be cured (50% vs. 14%; p = 0.010) and less likely to have treatment failure (14% vs. 68%; p < 0.001) compared to placebo | Adverse events * more frequently occurred in treatment compared to placebo group (44% vs. 14%; p = 0.014); * self-limiting diarrhoea | ||
De Moor et al., 2012 [40] | 12679; 12–75 | Retrospective | Mometasone furoato nasal spray (MNS) vs. MNS plus antibiotic vs. antibiotic | MNS (alone or in combination with antibiotic) significantly reduced the risk of rhinosinusitis-related medical encounters compared to antibiotic alone | |||
Poachanukoon et al., 2012 [44] | ARS (103) and CRS (51) | 154; 5.9 ± 3.3 | Prospective non-randomised | Amoxicillin-clavulanic acid (54.5%), cefditoren pivoxil (33.8%) for 14.6 ± 3.8 days (ARS) or 22.3 ± 5.0 days (CRS); intravenous antibiotic in 5.8% of cases (77.8% with ARS) | Symptomatic improvement in ARS group after 14.6 days of treatment on average and in CRS group after 22.3 days of treatment on average; no one underwent surgery | ||
Wan et al., 2015 [49] | Allergic rhinitis in 50% | 100; 15 ± 1.7 | Retrospective | Amoxicillin-clavulanic acid vs. amoxicillin-clavulanic acid plus intranasal corticosteroid vs. placebo | Symptom improvement in 92% and 88% of patients receiving amoxicillin-clavulanic acid with and without allergic rhinitis, respectively, compared to symptom improvement in 84% and 96% of patients receiving amoxicillin-clavulanic acid plus intranasal corticosteroid with and without allergic rhinitis, respectively; symptomatic improvement in 30% of placebo group | ||
Ragab et al., 2015 [41] | 62; 5.4 ± 2.3 and 4.6 ± 2.0 | Prospective randomised | Amoxicillin 100 mg/kg/day, three times a day, plus nasal saline irrigations vs. placebo plus nasal saline irrigations | Clinical recovery in 83.9% and 71% of patients respectively belonging to study and control group (not significant); clinical improvement in 3% and 6% of patients respectively belonging to study and control group | Adverse events in 58.1% * and 25.8% of patients respectively belonging to study and control group (p = 0.005); * including diarrhoea (29.0%), abdominal pain (16.1%), and nausea (6.0%) |
Author, Year | Pts Category | No. of Pts; Age (Years) | Study Design | Interventions | Outcomes | Failures and Side Effects |
---|---|---|---|---|---|---|
Poachanukoon et al., 2012 [44] | ARS (103) and CRS (51) | 154; 5.9 ± 3.3 | Prospective non-randomised | Amoxicillin-clavulanic acid (54.5%), cefditoren pivoxil (33.8%) for 14.6 ± 3.8 days (ARS) or 22.3 ± 5.0 days (CRS); intravenous antibiotic in 5.8% of cases (77.8% with ARS) | Symptomatic improvement in ARS group after 14.6 days of treatment on average and in CRS group after 22.3 days of treatment on average; no one underwent surgery | |
Shin et al., 2015 [45] | CRS (62.1% non-respondents and 37.9% respondents) | 58 with CRS; 5.8 ± 3.0 and 5.6 ± 2.7 | Prospective non-randomised | Amoxicillin (90 mg/kg/day) with clavulanic acid (6.4 mg/kg/day), second-or third-generation cephalosporines for 12 weeks | Symptomatic, clinical, or radiological recovery in 62.1% | Lack of response to antibiotic treatment was significantly related to increased total eosinophilic count and serum eosinophilic cationic protein levels |
Veskitkul et al., 2015 [42] | RARS (IgG subclass deficiency in 78.7%) | 94; 7.7 ± 2.6 | Retrospective | Oral antibiotic prophylaxis in 61.5% * (± adenotonsillectomy, allergen immunotherapy, gentamicin nasal irrigations, intravenous immunoglobulins); * amoxicillin or azithromycin | Symptomatic improvement in 80% of patients receiving antibiotic | |
Veskitkul et al., 2017 [43] | RARS | 60; 5–15 | Prospective randomised | Azithromycin 5 mg/kg/day for 3 days a week for 12 months | Number of acute episodes significantly reduced in children receiving antibiotic compared to controls with a number needed to treat = 2; subjective improvement and reduced adjunctive medication in study but not control group |
Author, Year | Pts Category | No. of Pts; Age (Years) | Study Design | Interventions | Outcomes | Failures and Side Effects | ||
---|---|---|---|---|---|---|---|---|
Kristo et al., 2009 [50] | Orbital complications | 20; 6.4 (8.0–12.4) | Retrospective | Parenteral antibiotic * (surgery in 10%); * cefuroxime (80.0%), clindamycin (10.0%), combined (10.0%) | Complete recovery in 100% | |||
Hurley et al., 2011 [51] | SPA | 42; <9 years | Retrospective | Parenteral antibiotic: combined therapy with either amoxicillin-sulbactam or a third-generation cephalosporin, and either clindamycin or vancomycin for 2–8 days, followed by amoxicillin-clavulanate for 2–3 weeks | Complete recovery in 97.6% | One patient readmitted and underwent surgery | ||
Gavriel et al., 2011 [46] | SPA | 48; 4.0 ± 3.5 | Retrospective | Parenteral antibiotic * (surgery in 47.6%); *amoxicillin-clavulanic acid (83.3%), ceftriaxone (10.0%), clindamycin plus metronidazole (8.3%), cefuroxime (2%) | Children with an abscess >0.5 mL should be candidates for surgery; conservative treatment can be considered only in those with smaller abscess without visual impairment | |||
Ketenci et al., 2013 [47] | SPA | 36; 3–76 (47.2% < 10 years) | Retrospective | Ampicillin with or without metronidazole or clindamycin as first choice (ampicillin in 64.0%, multiple antibiotics* in 36.0%); * ampicillin-sulbactam, clindamycin, sulperazone, metronidazole; 3–9 days for medial, 6–10 days for superior, and 3–4 days for inferior SPA location | Visual recovery in 47.21%; partial visual recovery in 5.5% | Unilateral blindness in 5.5%. Early recurrences in 5.5% (second surgery); late recurrence in 2.8% (first surgery); intracranial abscess with fatal outcome in 2.8% (repeated surgery) | ||
Schupper et al., 2018 [48] | Intracranial complications | 16; 5–17 | Retrospective | Parenteral antibiotic (vancomycin, meropenem, and ceftriaxone) with sinus surgery (plus craniotomy in 68.0%) | Abscess reaccumulation in 37.5%. Allergic reaction (12.0% to ceftriaxone, vamcomycin), meropenem-induced neutropenia (6.0%) |
Author, Year | Document | Recommendation |
---|---|---|
Chow et al., 2012 [52] | IDSA guideline | Amoxicillin-clavulanate. In patients with risk factors *, amoxicillin-clavulanate (90 mg/kg/day in two doses) or third-generation cephalosporin plus clindamycin for 10–14 days. In the case of non-type I hypersensitivity, third-generation cephalosporin plus clindamycin, doxycycline |
Wald et al., 2013 [53] | AAP guidelines | Amoxicillin or amoxicillin-clavulanate in children with severe onset or worsening for 10–28 days. Intravenous or intramuscular ceftriaxone (50 mg/kg) if oral therapy is not possible. In the case of non-type I hypersensitivity cefdinir, cefuroxime; in the case of type-I hypersensitivity, cefdinir, cefuroxime or cefixime plus clindamycin |
Wald and de Muri, 2018 [54] | Expert opinion | Amoxicillin-clavulanate (45 mg/kg/day) in two doses |
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Torretta, S.; Drago, L.; Marchisio, P.; Gaini, L.; Guastella, C.; Moffa, A.; Rinaldi, V.; Casale, M.; Pignataro, L. Review of Systemic Antibiotic Treatments in Children with Rhinosinusitis. J. Clin. Med. 2019, 8, 1162. https://doi.org/10.3390/jcm8081162
Torretta S, Drago L, Marchisio P, Gaini L, Guastella C, Moffa A, Rinaldi V, Casale M, Pignataro L. Review of Systemic Antibiotic Treatments in Children with Rhinosinusitis. Journal of Clinical Medicine. 2019; 8(8):1162. https://doi.org/10.3390/jcm8081162
Chicago/Turabian StyleTorretta, Sara, Lorenzo Drago, Paola Marchisio, Lorenzo Gaini, Claudio Guastella, Antonio Moffa, Vittorio Rinaldi, Manuel Casale, and Lorenzo Pignataro. 2019. "Review of Systemic Antibiotic Treatments in Children with Rhinosinusitis" Journal of Clinical Medicine 8, no. 8: 1162. https://doi.org/10.3390/jcm8081162