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Saturday, December 17, 2011

Are systemic corticosteroids effective in relieving symptoms of acute sinusitis?

Systemic corticosteroids are frequently used to treat acute sinusitis. A recent analysis of the Cochrane Central Register of Controlled Trials (CENTRAL) assess the effectiveness of systemic corticosteroids in relieving symptoms of acute sinusitis.

Four randomized controlled trials with a total of 1008 adult participants met the inclusion criteria. All participants received oral antibiotics and were assigned to either oral corticosteroids (prednisone 24 mg to 80 mg daily or betamethasone 1 mg daily) or the control treatment (placebo in three trials and non-steroidal anti-inflammatory drugs in one trial). In all trials, participants treated with oral corticosteroids were more likely to have short-term resolution or improvement of symptoms than those receiving the control treatment: at Days 3 to 7. An analysis of the three trials with placebo as a control treatment showed similar results but with a lesser effect size: No data on the long-term effects of oral corticosteroids on this condition, such as effects on relapse or recurrence rates was identified. Reported side effects of oral corticosteroids were limited and mild.

It was concluded that that oral corticosteroids as an adjunctive therapy to oral antibiotics are effective for short-term relief of symptoms in acute sinusitis. However, data are limited and there is a significant risk of bias. High quality trials assessing the efficacy of systemic corticosteroids both as an adjuvant and a monotherapy in primary care patients with acute sinusitis should be initiated.

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