Adjunct effect of loratadine in the treatment of acute sinusitis in patients with allergic rhinitis

Abstract

H1-blockers are often added to the standard treatment of acute sinusitis, but this is not supported by a controlled study. A multicentric, randomized, double-blind, placebo-controlled, parallel-group study was done in 139 allergic patients (15-65 years) to assess the adjunct efficacy of loratadine in acute exacerbation of rhinosinusitis. Sinusitis was diagnosed by symptoms and confirmed by rhinoscopy and sinus radiograph. Allergy was characterized by skin tests, RAST, and history. Patients were treated with antibiotics (14 days), oral corticosteroids (10 days), and loratadine (10 mg OD) or placebo (28 days). Treatment efficacy was assessed over 28 days by symptom scores quoted daily by patients. Physicians also rated total symptom scores at entry and at day 28. At entry, both groups had similar symptoms. Placebo-treated patients improved significantly, but patients who received loratadine had a significantly greater improvement in sneezing (P = 0.003) after 14 days, and in nasal obstruction (P = 0.002) after 28 days. Physicians found that patients receiving loratadine were significantly improved compared to placebo patients (P = 0.0125). Loratadine in addition to standard therapy was found to improve the control of some symptoms of sinusitis.

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

“…Loratadine, as an adjunctive therapy of atopic patients with acute sinusitis, was found to modestly improve sneezing and nasal obstruction (2115). It is also noteworthy to mention that half of the allergic patients with a history of sinus surgery and undergoing immunotherapy believed that surgery alone was not sufficient to completely resolve the recurrent episodes of infection related to their sinus disease (2116).…”

Acute Sinusitis in Outpatient Clinical Practice: Current Guidelines for the Diagnosis and Treatment Of

“…В основе механизма их действия лежит вазоконстрикция сосудов слизистой оболочки, что, по данным исследований, значительно уменьшает заложенность носа [25,26]. Одним из пред-ставителей этой группы является Отривин.…”

Estudio comparativo de los hallazgos radiográficos pre y post tratamiento en pacientes con diagnóstico clínico de sinusitis maxilar aguda.

“…Además por la continuidad de la mucosa nasal con la mucosa sinusal es imposible aislar la rinitis de la sinusitis. Por esta razón muchos investigadores prefieren usar el término Rinosinusitis (13). Raramente el paciente acude al consultorio por una rinosinusitis de más de tres semanas de evolución, debido a que las molestias sinusales interfieren con su vida cotidiana y laboral.…”