{"id":62,"date":"2012-02-08T15:10:43","date_gmt":"2012-02-08T23:10:43","guid":{"rendered":"https:\/\/phcprimarycare.org\/?p=62"},"modified":"2014-02-19T13:47:07","modified_gmt":"2014-02-19T21:47:07","slug":"oral-steroids-added-to-antibiotics-beneficial-for-chronic-rhinosinusitis-in-children-and-adolescents","status":"publish","type":"post","link":"https:\/\/phcprimarycare.org\/?p=62","title":{"rendered":"Oral steroids added to antibiotics beneficial for chronic rhinosinusitis in children and adolescents"},"content":{"rendered":"<p>So many published studies spend large amounts of time and money to show tiny improvements in care and which have large NNT (number needed to treat to help one person). It is refreshing and important to note studies that unequivocally change <!--more-->the standard of care and dramatically improve outcomes.<\/p>\n<p>In a randomized, double-blinded, controlled trial of treatment of chronic rhinosinusitis (lasting greater than 3 months), researchers in Turkey found that the rate of improvement and cure of disease roughly doubled (based on symptoms, and CT-scan followup) when systemic steroids (a 15-day taper) were added to antibiotic treatment (30 days) in children and adolescents.\u00a0(Number needed to treat about 2; see link to reference, below).<\/p>\n<p>In other studies, inhaled nasal corticosteroids are a cornerstone of treatment of chronic sinusitis; it would be interesting to compare nasal corticosteroids to systemic corticosteroids (both with oral antibiotics) head-to-head in children.<\/p>\n<p>In adults, UpToDate\u00ae recommends systemic corticosteroids only in specific cases:\u00a0unraveling puzzling cases, to reduce swelling in fungal sinusitis, and for reducing the size of polyps in adults with chronic sinusitis associated with nasal polyposis.<\/p>\n<p>Robert Moore, MD, MPH<\/p>\n<div>Reference<\/div>\n<div><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/query.fcgi?cmd=Retrieve&amp;db=PubMed&amp;list_uids=21624649&amp;dopt=Abstract\" target=\"_blank\">Ozturk F, Bakirtas A, Iieri F, Turktas I. Efficacy and tolerability of systemic methylprednisolone in children and adolescents with chronic rhinosinusitis: A double-blind, placebo-controlled randomized trial. J Allergy Clin Immunol 2011;128(2):342-352.<\/a><\/div>\n","protected":false},"excerpt":{"rendered":"<p>So many published studies spend large amounts of time and money to show tiny improvements in care and which have large NNT (number needed to treat to help one person). It is refreshing and important to note studies that unequivocally &hellip; <a href=\"https:\/\/phcprimarycare.org\/?p=62\">Continue reading <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[6],"tags":[],"class_list":["post-62","post","type-post","status-publish","format-standard","hentry","category-formulary-pharmacy-issues"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.2 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Oral steroids added to antibiotics beneficial for chronic rhinosinusitis in children and adolescents - PHC Primary Care Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/phcprimarycare.org\/?p=62\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Oral steroids added to antibiotics beneficial for chronic rhinosinusitis in children and adolescents - PHC Primary Care Blog\" \/>\n<meta property=\"og:description\" content=\"So many published studies spend large amounts of time and money to show tiny improvements in care and which have large NNT (number needed to treat to help one person). It is refreshing and important to note studies that unequivocally &hellip; Continue reading &rarr;\" \/>\n<meta property=\"og:url\" content=\"https:\/\/phcprimarycare.org\/?p=62\" \/>\n<meta property=\"og:site_name\" content=\"PHC Primary Care Blog\" \/>\n<meta property=\"article:published_time\" content=\"2012-02-08T23:10:43+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2014-02-19T21:47:07+00:00\" \/>\n<meta name=\"author\" content=\"RMoore\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"RMoore\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/phcprimarycare.org\/?p=62\",\"url\":\"https:\/\/phcprimarycare.org\/?p=62\",\"name\":\"Oral steroids added to antibiotics beneficial for chronic rhinosinusitis in children and adolescents - PHC Primary Care Blog\",\"isPartOf\":{\"@id\":\"https:\/\/phcprimarycare.org\/#website\"},\"datePublished\":\"2012-02-08T23:10:43+00:00\",\"dateModified\":\"2014-02-19T21:47:07+00:00\",\"author\":{\"@id\":\"https:\/\/phcprimarycare.org\/#\/schema\/person\/e2261897cb15c2610b283200b210f79c\"},\"breadcrumb\":{\"@id\":\"https:\/\/phcprimarycare.org\/?p=62#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/phcprimarycare.org\/?p=62\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/phcprimarycare.org\/?p=62#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/phcprimarycare.org\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Oral steroids added to antibiotics beneficial for chronic rhinosinusitis in children and adolescents\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/phcprimarycare.org\/#website\",\"url\":\"https:\/\/phcprimarycare.org\/\",\"name\":\"PHC Primary Care Blog\",\"description\":\"Partnership HealthPlan of California\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/phcprimarycare.org\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/phcprimarycare.org\/#\/schema\/person\/e2261897cb15c2610b283200b210f79c\",\"name\":\"RMoore\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/phcprimarycare.org\/#\/schema\/person\/image\/\",\"url\":\"https:\/\/secure.gravatar.com\/avatar\/f0ba7e9946a1ad594a0070ed009f75ea00cb69b3f7271511fd722377966e54bd?s=96&d=mm&r=g\",\"contentUrl\":\"https:\/\/secure.gravatar.com\/avatar\/f0ba7e9946a1ad594a0070ed009f75ea00cb69b3f7271511fd722377966e54bd?s=96&d=mm&r=g\",\"caption\":\"RMoore\"},\"url\":\"https:\/\/phcprimarycare.org\/?author=2\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Oral steroids added to antibiotics beneficial for chronic rhinosinusitis in children and adolescents - PHC Primary Care Blog","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/phcprimarycare.org\/?p=62","og_locale":"en_US","og_type":"article","og_title":"Oral steroids added to antibiotics beneficial for chronic rhinosinusitis in children and adolescents - PHC Primary Care Blog","og_description":"So many published studies spend large amounts of time and money to show tiny improvements in care and which have large NNT (number needed to treat to help one person). 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