A randomized controlled trial of azithromycin and amoxycillin/clavulanate in the management of subacute childhood rhinosinusitis

Ng, David; Chow, Pok-yu; Leung, LD; Chau, Ken; Chan, Elena; Ho, Jackson C.

doi:10.1046/j.1440-1754.2000.00526.x

Cited by 10 publications

(6 citation statements)

References 17 publications

(24 reference statements)

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“…[124][125][126] In general, a 10-to 14-day treatment course is recommended for the majority of children, tailored to a patient's response (e.g. However, treatment courses as short as 1 to 5 days in children have had encouraging clinical results in a limited number of trials.…”

Section: Surgery For Sinusitis Complicationsmentioning

confidence: 99%

Sinusitis

Chan¹,

Abzug²,

Liu³

2016

Pediatric Allergy: Principles and Practice

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Section: Surgery For Sinusitis Complicationsmentioning

confidence: 99%

Sinusitis

Chan¹,

Abzug²,

Liu³

2016

Pediatric Allergy: Principles and Practice

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“…3 Three small randomized controlled trials assessing the efficacy of different treatment strategies for subacute sinusitis were identified (Table 7). [25][26][27] None of these studies included a placebo group. One compared empirical amoxicillin/clavulanate with culture-based (from nasal mucosa) antimicrobial treatment.…”

Section: Subacute Sinusitismentioning

confidence: 99%

“…Another study compared azithromycin versus amoxicillin/clavulanate. 26 The third compared amoxicillin, amoxicillin/clavulanic acid, trimethoprim/sulfamethoxazole, and no antimicrobial therapy. 27 In these 2 studies, no advantage was detected in any treatment arm compared with others.…”

Section: Subacute Sinusitismentioning

confidence: 99%

“…One study of subacute sinusitis included 52 sinus aspirations of 40 children with subacute (30-120 days of symptoms) sinusitis and found similar pathogens as in acute sinusitis. 28 The definition of subacute sinusitis used in this study and in the study be Ng et al 26 were derived from an expert consensus panel. 29 The study by El-Hennawi et al 23 cites the 2001 AAP guidelines, and the study by Dohlman et al 25 does not provide a reference for the study definition of subacute sinusitis.…”

Section: Clinical Questions For Which High-quality Data Are Lackingmentioning

confidence: 99%

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Evidence for the Diagnosis and Treatment of Acute Uncomplicated Sinusitis in Children: A Systematic Review

Smith¹

2013

Pediatrics

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In 2001, the American Academy of Pediatrics published clinical practice guidelines for the management of acute bacterial sinusitis (ABS) in children. The technical report accompanying those guidelines included 21 studies that assessed the diagnosis and management of ABS in children. This update to that report incorporates studies of pediatric ABS that have been performed since 2001. Overall, 17 randomized controlled trials of the treatment of sinusitis in children were identified and analyzed. Four randomized, double-blind, placebo-controlled trials of antimicrobial therapy have been published. The results of these studies varied, likely due to differences in inclusion and exclusion criteria. Because of this heterogeneity, formal meta-analyses were not performed. However, qualitative analysis of these studies suggests that children with greater severity of illness at presentation are more likely to benefit from antimicrobial therapy. An additional 5 trials compared different antimicrobial therapies but did not include placebo groups. Six trials assessed a variety of ancillary treatments for ABS in children, and 3 focused on subacute sinusitis. Although the number of pediatric trials has increased since 2001, there are still limited data to guide the diagnosis and management of ABS in children. Diagnostic and treatment guidelines focusing on severity of illness at the time of presentation have the potential to identify those children most likely to benefit from antimicrobial therapy and at the same time minimize unnecessary use of antibiotics.

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“…Two small, randomized trials have evaluated short courses of antibacterials in children. Ficnar et al [39] compared 3 versus 5 days of azithromycin and Ng et al [40] compared 3 days of azithromycin versus 14 days amoxicillin/clavulanate. Acknowledging the small sample size of these trials, no difference in efficacy between short and long courses of the tested antibacterials was demonstrated.…”

Section: Short Courses Of Antibioticsmentioning

confidence: 99%

Treatment options for acute sinusitis in children

Contopoulos‐Ioannidis

Ioannidis

2004

Curr Allergy Asthma Rep

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Much controversy exists regarding the best diagnostic method for acute sinusitis, the efficacy of antibiotics, the best choice of antibiotics, the most appropriate duration of therapy, and the efficacy of ancillary measures and nasal corticosteroids. The therapeutic goal is to identify those children who are more likely to have bacterial sinusitis and unlikely to resolve spontaneously, who may require treatment with antibiotics. The inaccuracy of clinical signs and symptoms complicates further the management of these children. Acute sinusitis is expected to resolve spontaneously in most cases, including many cases of bacterial sinusitis. Antibiotics are needed only for a minority of non-self-resolving infections. Based on current resistance considerations, approximately 80% of bacterial infections are expected to respond to standard doses of amoxicillin. High-dose amoxicillin, amoxicillin/clavulanate, or other b-lactam antibiotics should be considered for children at high risk for carrying resistant organisms. Evidence for the effectiveness of ancillary measures is limited.

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A randomized controlled trial of azithromycin and amoxycillin/clavulanate in the management of subacute childhood rhinosinusitis

Abstract: This small study did not provide evidence of a difference between 14 days of amoxycillin/clavulanate and 3 days of azithromycin. Larger studies will be needed to determine which, if any, antibiotic regimen should be used in treating subacute childhood rhinosinusitis.

Cited by 10 publications

References 17 publications

Sinusitis

Sinusitis

Evidence for the Diagnosis and Treatment of Acute Uncomplicated Sinusitis in Children: A Systematic Review

Treatment options for acute sinusitis in children

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