Table 1.

Studies of Antibiotic Treatment and Ancillary Measures in the Management of Acute Sinusitis in Children*

Author (Year)NAge (Years)Abnormal RadiographClinical Symptoms
and Signs
AntibioticDuration (Days)Ancillary Measures
ANTIBIOTICS
Randomized
 Ficnar (1997)10 27½–12RequiredYes, but not specifiedAzithromycin3ND
18Azithromycin5ND
 Careddu (1993)11 252–14NDNot mentioned how diagnosedBrodimoprim8ND
27Amoxicillin/clavulanate8?ND
 Wald (1986)12 282–16RequiredNasal discharge or cough >10 d requiredAmoxicillin/clavulanate10Antihistamines
30Amoxicillin
35Placebo
 Wald (1984)13 271–16RequiredSpecified severe or persistent symptomsAmoxicillin10Antihistamines
23Cefaclor
 Jeppesen (1972)14 7 6–10RequiredSecretions, edema, dilated vessels on sinoscopyPivampicillin 7–30Decongestant + lavage
8 Placebo
Case series
 Hager (1980)18 301–12RequiredRed and swollen mucosa with dischargeCo-trimazine10ND
 Helin (1982)19 611–15RequiredVarious reportedPenicillin v10Nose drops and PPA
16Pivampicillin10Nose drops and PPA
15Erythromycin10Nose drops and PPA
 Nylen (1972)20 255–15Not requiredYes, but not specifiedPenicillin10Decongestants for 7 d
 Gurses (1996)21 395–14RequiredVarious reportedCefuroxime7ND
 Herz (1977)22 1066–17RequiredVarious reportedDoxycycline10–28ND
 Puhakka (1986)23 140–15Not requiredPurulent drainage; transillumination (required?)Cefadroxil 7–17ND
 McLean (1970)24 254–15RequiredVarious reportedVarious14–21ND
 Aitken (1998)25 681–5Not requiredNasal congestion/drainage ± cough >9 d requiredVariousvariousND
19None
ANCILLARY
 Barlan (1997)15 432–14Not required Required specified major and minor criteria§ Amoxicillin/clavulanate21Budenoside
461–15Placebo
 Revonta (1982)16 504–10Not required No symptoms of sinusitis except for rhinnorheaAmoxicillin10PPA + lavage
36PPA only
 McCormick (1996)17 341–18RequiredSymptom score used; components not mentionedAmoxicillin14Triple combination
34Placebo
  • * PPA indicates phenylpropanolamine; ND, no data available.

  • Number of sinuses.

  • Abnormal in 68/89 of patients performed.

  • § At least 2 of 3 major criteria (purulent nasal discharge, pharyngeal drainage, cough) or 1 major and 2 of 9 prespecified minor criteria were required for the diagnosis.

  • Radiograph abnormalities were seen in 168/452 children who came for adenoidectomy or adenotonsillectomy without having any clinical symptoms of sinusitis.