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Topical treatment of rhinosinusitis
Author(s) -
Fiocchi A.,
Sarratud T.,
Bouygue G. R.,
Ghiglioni D.,
Bernardo L.,
Terracciano L.
Publication year - 2007
Publication title -
pediatric allergy and immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.269
H-Index - 89
eISSN - 1399-3038
pISSN - 0905-6157
DOI - 10.1111/j.1399-3038.2007.00637.x
Subject(s) - medicine , decongestant , nasal decongestant , evidence based medicine , sinusitis , intensive care medicine , topical steroid , critical appraisal , medline , clinical trial , dermatology , antihistamine , medical literature , pediatrics , alternative medicine , surgery , anesthesia , pathology , political science , law
We reviewed current clinical evidence for the use of topical treatments in pediatric rhinosinusitis. Repeated Entrez PubMed searches were done using the template algorithm [rhinosinusitis AND (…)] with the settings: [Humans; English; All Child 0–18; Clinical trial; Last 10 yr] for the following comparators: steroid, irrigation, saline, antihistamine, decongestant, antibiotic, antimycotic, fungicide. The authors’ clinical experience in the pediatric allergy unit of a university hospital was also drawn upon. Pediatric studies were retrieved but only one satisfied current evidence‐based medicine standards for reporting clinical trials. Studies could not be systematized because of methodological, analytical, and interpretation biases. While saline irrigation, nasal decongestants, steroids, antibiotics, antihistamines and fungicides are all in widespread pediatric use, comparing studies from the literature for evidence of efficacy implied subjective appraisal, except in the case of topical steroids. Evidence for the efficacy of topical treatment for pediatric rhinosinusitis is narrative albeit this modality cannot be excluded from individualized patient protocols on the basis of the clinical literature alone. With the exception of topical steroids, no weighable evidence of effectiveness supports the premise that topical treatments actually serve the purpose for which they are widely prescribed in pediatrics.