Management of clinically diagnosed subacute rhinosinusitis in children under the age of two years: a randomized, controlled study

Abstract

Background: In children, a diagnosis of rhinosinusitis is usually made on clinical grounds. Subacute rhinosinusitis (SRS) may be the cause of persistent cough, low-grade fever, snoring, ear problems and difficult feeding in children under the age of two years.Objective: To compare the efficacy of culture-based antibiotics and empiric amoxicillin–clavulanate (40 mg/kg/day) in treating SRS in children under the age of two years.Study design: Randomized, controlled study.Population: Sixty children with persistent nasal discharge and nasal obstruction (and other related symptoms) for 30–90 days.Methods: Group one (n = 30) received culture-based antibiotics and group two (n = 30) were treated empirically with 40 mg/kg/day of amoxicillin–clavulanate. Treatment was continued for two weeks.Results: At the end of the three-week follow-up period, statistically significant greater improvements in nasal obstruction (p = 0.037) and nasal discharge (p = 0.003) were seen in group one compared with group two.Conclusion: culture-based antibiotics were more efficacious than empiric amoxicillin–clavulanate (40 mg/kg/day) in treating SRS in children under the age of two years.