According to a review presented by Anca Zalmanovici, a family physician at Rabin Medical Center in Petach Tikva, and her co-author, stronger doses of nasal steroids seem to be a better option than any other treatment option concerned with acute sinusitis.
This review appeared in an issue of The Cochrane Library, a publication of The Cochrane Collaboration, which is an organization of international status evaluating research in the segments of health care. It was remarked by Allen Seiden, M.D., director of the University of Cincinnati Taste and Smell Center, that more data is required before any routine recommendations on intranasal corticosteroids can be made.
From News-Medical.Net:
Study participants, who underwent X-rays or nasal endoscopy to confirm diagnosis, received either a placebo or intranasal corticosteroids for two or three weeks, alone or in combination with antibiotics. Intranasal corticosteroids used included fluticasone propionate (Flonase), mometasone furoate (Nasonex) and budesonide (Rhinocort).
Overall, 73 percent of the patients treated with nasal steroids experienced relief or marked improvement of symptoms during the study period, compared with only 66.4 percent of patients who received the placebo.
“For every 100 patients treated with intranasal corticosteroids, seven additional patients had complete or marked symptom relief,” compared to those in the placebo group, the reviewers found.
Researchers pooled data from three of the four studies, excluding the lowest-quality study from the statistical analysis.
None of the studies reported serious side effects, and rates of sinusitis relapse were similar between the treatment and placebo groups.
Stronger doses of nasal steroids appeared to work better. Patients receiving daily doses of 400 micrograms were more likely to experience relief of sinusitis symptoms, than were patients receiving 200-microgram doses.
According to the involved researchers, the study results and reviews suggest the present clinical rationale of adding an intranasal corticosteroid to antibiotic therapy is justified to a great extent.
