xRead - Nasal Obstruction (September 2024) Full Articles

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International consensus statement on rhinosinusitis

uncomplicated pediatric ARS. If > 10days or complicated,

Strong Recommendation: Consider use in ARS

Recommendation: Antibiotics should not be given for the first 10 days of

amoxicillin-clavulanate is

preferred antibiotic if not allergic

Option: Saline irrigation may be used in adjunct with antibiotics for acute

bacterial rhinosinusitis.

Option: Consider watchful waiting in uncomplicated

cases with institution after 7 days or with worsening/ mitigating circumstances

Benefit-Harm Assessment Policy Level

Low Benefit over placebo small but tangible

outweigh harms and costs

Low Balance of benefit and harm

Benefit over placebo is small

None Benefits likely

Moderate

TABLE I-3 Grade A/B evidence-based recommendations for medical management of ARS Intervention Grade Benefit Harm Cost ARS: Antibiotic Treatment B Shorter symptom duration, reduced pathogen carriage GI complaints, resistance, anaphylaxis; See Table II-1. Lowto Pediatric ARS < 10 days: Withholding Antibiotic Treatment A Avoidance of unnecessary medications Potential progression of disease ARS: Intranasal Corticosteroids A Improved symptoms as Minimal harm with rare adverse events; See Table II-1.

Unclear but possible ear fullness, or

irritation; See Table II-1.

monotherapy in mild to moderate cases and as

adjuvant to antibiotics in severe cases. May shorten recovery

B No benefit to 10 cc syringe but possible improvement in

patency, rhinorrhea,

and post-nasal drip with high volume irrigation

ARS: Topical Saline Sprayand Irrigation