Intranasal corticosteroids in management of acute sinusitis: a systematic review and meta-analysis.
نویسندگان
چکیده
PURPOSE Acute sinusitis is a common condition in ambulatory care, where it is frequently treated with antibiotics, despite little evidence of their benefit. Intranasal corticosteroids might relieve symptoms; however, evidence for this benefit is currently unclear. We performed a systematic review and meta-analysis of the effects of intranasal corticosteroids on the symptoms of acute sinusitis. METHODS We searched MEDLINE, EMBASE, the Cochrane Central register of Controlled Trials (CENTRAL), and Centre for Reviews and Dissemination databases until February 2011 for studies comparing intranasal corticosteroids with placebo in children or adults having clinical symptoms and signs of acute sinusitis or rhinosinusitis in ambulatory settings. We excluded chronic/allergic sinusitis. Two authors independently extracted data and assessed the studies' methodologic quality. RESULTS We included 6 studies having a total of 2,495 patients. In 5 studies, antibiotics were prescribed in addition to corticosteroids or placebo. Intranasal corticosteroids resulted in a significant, small increase in resolution of or improvement in symptoms at days 14 to 21 (risk difference [RD] = 0.08; 95% CI, 0.03-0.13). Analysis of individual symptom scores revealed most consistently significant benefits for facial pain and congestion. Subgroup analysis by time of reported outcomes showed a significant beneficial effect at 21 days (RD = 0.11; 95% CI, 0.06-0.17), but not at 14 to 15 days (RD = 0.05; 95% CI, -0.01 to 0.11). Meta-regression analysis of trials using different doses of mometasone furoate showed a significant dose-response relationship (P=.02). CONCLUSIONS Intranasal corticosteroids offer a small therapeutic benefit in acute sinusitis, which may be greater with high doses and with courses of 21 days' duration. Further trials are needed in antibiotic-naïve patients.
منابع مشابه
Effectiveness of Fresh Frozen Plasma in Management of Acute Organophosphate Intoxicated Patients: An Updated Systematic Review and Meta-Analysis
متن کامل
Efficacy and safety of inhaler steroids in COPD patients: Systematic review and meta-analysis of randomized placebo-controlled trials
Background: Chronic obstructive pulmonary disease (COPD) is a major health dilemma and cause of morbidity and mortality in either industrialized or developing countries and inhaled corticosteroids are widely used worldwide in these patients. In this systematic review, we aimed to analyze the effectiveness of these gents compared to placebo. Methods: Pubmed and Google Scholar literature search ...
متن کاملEpiglottitis in Pre and Post Haemophilus Influenza Type-b Vaccine Era: A Systematic Review and Meta-analysis
Background and purpose: Epiglottitis is an uncommon life threatening pediatric disease. Evidence suggests some changes in etiology and incidence of this disease after vaccination against H-influenza type b. This Meta-analysis and systematic review aimed at investigating the etiology and incidence of acute epiglottitis in pre and post H-influenza vaccination era. Materials and methods: A system...
متن کاملMeta-analysis (systematic review) of profit management antecedents and explaining the effect of company size adjuster
The purpose of the present study is to meta-analyze (systematic review) of profit management antecedents and explain the moderating effect of company size. The statistical population of the article is 100 articles and dissertations published during the years 1387 to 1398. Based on the research method, 48 studies were reviewed as the final sample. The present study was done by meta-analysis usin...
متن کاملEfficacy of radiosynovectomy in the treatment of chronic knee synovitis: Systematic review and meta-analysis
Introduction: Knee joints are commonly involved with various inflammatory and non- inflammatory rheumatic diseases. Radiosynovectomy is being used as a local therapeutic option to alleviate pain and swelling in involved joints. The present study evaluated the effectiveness of radiosynovectomy for treatment of chronic knee synovitis. Methods: Through a search of Medline and SCOPUS with (Radiosy...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- Annals of family medicine
دوره 10 3 شماره
صفحات -
تاریخ انتشار 2012