抗生素治疗小儿急性鼻窦炎疗效不显著
【摘要】有研究指出：小儿急性鼻窦炎患者用抗生素治疗，效果不显著。【全文】Antibiotics don't speed sinusitis recovery: studyBy Merritt McKinneyNEW YORK, Apr 02 (Reuters Health) - Most children with cough, runny nose and other symptoms of sinus trouble are unlikely to benefit from antibiotics, researchers report.In a study of children diagnosed with acute sinusitis lasting at least 10 days, those given an inactive (placebo) pill were just as likely to get better as children prescribed antibiotics. Symptoms improved within 7 days in 81% of children in each group and within 10 days in 87% of all children."There was no benefit of antibiotics versus placebo for getting rid of symptoms," the study's first author, Dr. Jane M. Garbutt of Washington University in St. Louis, Missouri, told Reuters Health in an interview.The study included 188 patients aged 1 to 18 diagnosed with acute sinusitis. Symptoms such as cough, runny nose and green nasal discharge had lasted 10 to 28 days. Researchers did not enroll patients with more severe sinusitis, characterized by longer-lasting symptoms, facial pain and swelling and fever.Children were treated with a placebo or one of two types of antibiotics, amoxicillin or amoxicillin-clavulanate.The study also found that antibiotic therapy was no better than placebo for preventing the relapse or recurrence of symptoms, or reducing absences from school or day care. Side effects were similar in all three treatment groups, although children taking amoxicillin were more likely to experience abdominal pain, the researchers report in the April issue of the journal Pediatrics."It's a difficult study to report...(since) it doesn't make life any easier," according to Garbutt. Antibiotics "are not the panacea they were thought to be" for sinusitis, she continued.Although some parents are concerned that a child will develop complications if symptoms are left untreated, "that's highly unlikely," Garbutt stated."If you just hang in there, the children will get better on their own," she said.Garbutt acknowledged that diagnosing and treating sinusitis in children--and adults--is difficult, since there is no good diagnostic test. Even though x-rays are sometimes used to confirm a diagnosis of sinusitis, they are unreliable, she said.Most cases of sinusitis appear to be caused by viruses, against which antibiotics are powerless, Garbutt explained. But she noted that the study does not mean that antibiotics should never be used to treat sinusitis or other acute respiratory illnesses, only that they should be used "judiciously." Some children may have bacterial infections that will respond to antibiotics, so a doctor may prescribe antibiotics for some children with symptoms that will not go away on their own, she said.Since amoxicillin-clavulanate--known as a broad-spectrum antibiotic because it targets a wide variety of bacteria--was no better than amoxicillin alone at improving symptoms, amoxicillin appears to be a better choice if a doctor decides to prescribe an antibiotic for sinusitis. Prescribing the more targeted antibiotic may reduce the risk of developing antibiotic resistance in a variety of bacteria, she noted.While Garbutt said that there is little evidence that over-the-counter medications such as decongestants provide much relief to sinusitis sufferers, she said over-the-counter pain medications may help children feel better.The study was funded by the Hoechst Marion Roussel ACCORD Grants Program.SOURCE: Pediatrics 2001;107:619-625., 百拇医药