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General Health Channel
Reported August 8, 2012

Sinusitis Meds: Is It In Your Head?

(Ivanhoe Newswire) -- Bacteria are the most common direct cause of acute sinusitis. Doctors often prescribe corticosteroids such as Prednisone to block bacteria and treat symptoms, but new research shows it may not really be helping.

Acute sinusitis is characterized by inflammation of the nasal cavities, blocked nasal passages and sometimes headaches and facial pain. Antibiotics are a common treatment, despite the fact that the cause is often viral and will not respond to antibiotics. Corticosteroids are increasingly being used to alleviate symptoms, although the evidence for efficacy is inconclusive.

To determine the effectiveness of oral corticosteroids on acute rhinosinusitis (sinusitis), researchers conducted a randomized, double-blind controlled trial involving 174 adults with clinically diagnosed acute rhinosinusitis. 88 patients were randomized to a group that received 30 mg/d of prednisolone for a week and the remaining 86 received placebo. In the prednisolone group, 55 of 88 patients reported that their facial pain or pressure had resolved by day 7, versus 48 of 86 in the placebo group. Although there was a slight reduction of facial pain in the prednisolone group, the results were neither statistically nor clinically significant.

"We found no clinically relevant effect of systemic corticosteroid monotherapy among patients with clinically diagnosed, uncomplicated acute rhinosinusitis," Dr. Roderick Venekamp, University Medical Centre Utrecht, was quoted saying.

"There is no rationale for the use of corticosteroids in the broad population of patients with clinically diagnosed acute rhinosinusitis. Future studies should focus on identifying subgroups of patients who may benefit from intranasal or systemic corticosteroid treatment," Dr. Venekamp added.

Source: Canadian Medical Association Journal, August 2012

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