<!doctype html> <!--[if lt IE 7]> <html class="no-js lt-ie10 lt-ie9 lt-ie8 lt-ie7" lang="en"> <![endif]--> <!--[if IE 7]> <html class="no-js lt-ie10 lt-ie9 lt-ie8" lang="en"> <![endif]--> <!--[if IE 8]> <html class="no-js lt-ie10 lt-ie9" lang="en"> <![endif]--> <!--[if IE 9]> <html class="no-js lt-ie10" lang="en"> <![endif]--> <!--[if gt IE 9]><!--> <html class="no-js" lang="en"> <!--<![endif]--> <head> <meta name="viewport" content="width=device-width,initial-scale=1"> <link rel="shortcut icon" href="http://bmj.com/wp-content/themes/jnp-base/favicon.ico" /> <script>(function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','');</script> <script> var oas_tag = oas_tag || {}; oas_tag.url = 'oas.services.bmj.com'; oas_tag.sizes = function () { oas_tag.definePos('Top', [728,90]); oas_tag.definePos('Middle1', [300,250]); oas_tag.definePos('Bottom', [728,90]); }; oas_tag.site_page = window.location.hostname + window.location.pathname; oas_tag.query = ''; oas_tag.allowSizeOverride = true; oas_tag.analytics = true; oas_tag.taxonomy = ''; (function() { oas_tag.version ='1'; oas_tag.loadAd = oas_tag.loadAd || function(){}; var oas = document.createElement('script'), protocol = 'https:' == document.location.protocol?'https://':'http://', node = document.getElementsByTagName('script')[0]; oas.type = 'text/javascript'; oas.async = true; oas.src = protocol + oas_tag.url + '/om/' + oas_tag.version + '.js'; node.parentNode.insertBefore(oas, node); })(); </script> <link rel='dns-prefetch' href='//bmj.com' /> <link rel='dns-prefetch' href='//s.w.org' /> <script type="text/javascript"> window._wpemojiSettings = {"baseUrl":"https:\/\/s.w.org\/images\/core\/emoji\/2.2.1\/72x72\/","ext":".png","svgUrl":"https:\/\/s.w.org\/images\/core\/emoji\/2.2.1\/svg\/","svgExt":".svg","source":{"concatemoji":"http:\/\/bmj.com\/wp-includes\/js\/wp-emoji-release.min.js?ver=4.7.1"}}; !function(a,b,c){function d(a){var b,c,d,e,f=String.fromCharCode;if(!k||!k.fillText)return!1;switch(k.clearRect(0,0,j.width,j.height),k.textBaseline="top",k.font="600 32px Arial",a){case"flag":return k.fillText(f(55356,56826,55356,56819),0,0),!(j.toDataURL().length<3e3)&&(k.clearRect(0,0,j.width,j.height),k.fillText(f(55356,57331,65039,8205,55356,57096),0,0),b=j.toDataURL(),k.clearRect(0,0,j.width,j.height),k.fillText(f(55356,57331,55356,57096),0,0),c=j.toDataURL(),b!==c);case"emoji4":return k.fillText(f(55357,56425,55356,57341,8205,55357,56507),0,0),d=j.toDataURL(),k.clearRect(0,0,j.width,j.height),k.fillText(f(55357,56425,55356,57341,55357,56507),0,0),e=j.toDataURL(),d!==e}return!1}function e(a){var c=b.createElement("script");c.src=a,c.defer=c.type="text/javascript",b.getElementsByTagName("head")[0].appendChild(c)}var f,g,h,i,j=b.createElement("canvas"),k=j.getContext&&j.getContext("2d");for(i=Array("flag","emoji4"),c.supports={everything:!0,everythingExceptFlag:!0},h=0;h<i.length;h++)c.supports[i[h]]=d(i[h]),c.supports.everything=c.supports.everything&&c.supports[i[h]],"flag"!==i[h]&&(c.supports.everythingExceptFlag=c.supports.everythingExceptFlag&&c.supports[i[h]]);c.supports.everythingExceptFlag=c.supports.everythingExceptFlag&&!c.supports.flag,c.DOMReady=!1,c.readyCallback=function(){c.DOMReady=!0},c.supports.everything||(g=function(){c.readyCallback()},b.addEventListener?(b.addEventListener("DOMContentLoaded",g,!1),a.addEventListener("load",g,!1)):(a.attachEvent("onload",g),b.attachEvent("onreadystatechange",function(){"complete"===b.readyState&&c.readyCallback()})),f=c.source||{},f.concatemoji?e(f.concatemoji):f.wpemoji&&f.twemoji&&(e(f.twemoji),e(f.wpemoji)))}(window,document,window._wpemojiSettings); </script> <style type="text/css"> img.wp-smiley, img.emoji { display: inline !important; border: none !important; box-shadow: none !important; height: 1em !important; width: 1em !important; margin: 0 .07em !important; vertical-align: -0.1em !important; background: none !important; padding: 0 !important; } </style> <link rel='stylesheet' id='jnp-base-css' href='http://bmj.com/wp-content/themes/jnp-base/css/style.css?ver=4.7.1' type='text/css' media='all' /> <style id='jnp-base-inline-css' type='text/css'> .primary-color { background-color: !important; } div.widget-circles a:hover span { background-color: !important; } </style> <!--[if lt IE 9]> <script type='text/javascript' src='http://bmj.com/wp-content/themes/jnp-base/js/lib/html5shiv-3.7.3.min.js?ver=4.7.1'></script> <![endif]--> <script type='text/javascript' src='http://bmj.com/wp-includes/js/jquery/jquery.js?ver=1.12.4'></script> <script type='text/javascript' src='http://bmj.com/wp-includes/js/jquery/jquery-migrate.min.js?ver=1.4.1'></script> <script type='text/javascript'> /* <![CDATA[ */ var ajax_object = {"ajax_url":"http:\/\/bmj.com\/wp-admin\/admin-ajax.php"}; /* ]]> */ </script> <script type='text/javascript' src='http://bmj.com/wp-content/themes/jnp-base/js/jnp-base.js?ver=4.7.1'></script> <link rel='https://api.w.org/' href='http://bmj.com/wp-json/' /> <link rel="EditURI" type="application/rsd+xml" title="RSD" href="http://bmj.com/xmlrpc.php?rsd" /> <link rel="wlwmanifest" type="application/wlwmanifest+xml" href="http://bmj.com/wp-includes/wlwmanifest.xml" /> <meta name="generator" content="WordPress 4.7.1" /> <meta name='robots' content='noindex,follow' /> <style type="text/css"> .mu_register { width: 90%; margin:0 auto; } .mu_register form { margin-top: 2em; } .mu_register .error { font-weight:700; padding:10px; color:#333333; background:#FFEBE8; border:1px solid #CC0000; } .mu_register input[type="submit"], .mu_register #blog_title, .mu_register #user_email, .mu_register #blogname, .mu_register #user_name { width:100%; font-size: 24px; margin:5px 0; } .mu_register #site-language { display: block; } .mu_register .prefix_address, .mu_register .suffix_address {font-size: 18px;display:inline; } .mu_register label { font-weight:700; font-size:15px; display:block; margin:10px 0; } .mu_register label.checkbox { display:inline; } .mu_register .mu_alert { font-weight:700; padding:10px; color:#333333; background:#ffffe0; border:1px solid #e6db55; } </style> </head> <body class="home blog"> <noscript><iframe src="https://www.googletagmanager.com/ns.html?id=" height="0" width="0" style="display:none;visibility:hidden"></iframe></noscript> <div class="container"> <header> <section class="cookie closed"> <div id="close-cookie"><img src="//resources.bmj.com/repository/journals-network-project/images/wordpress/icon-close.png" srcset="data:image/svg+xml;base64,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"></div> <p>This site uses cookies. <span id="cookie-more">More info <img src="//resources.bmj.com/repository/journals-network-project/images/wordpress/icon-arrow-down.png" srcset="data:image/svg+xml;base64,PHN2ZyB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciIHZpZXdCb3g9IjAgMCA0OCA0OCI+PHBvbHlnb24gcG9pbnRzPSI5IDMzLjQgNy42IDMyLjEgMjQuNCAxNC42IDQwLjQgMzIuMSAzOC45IDMzLjQgMjQuNCAxNy41ICIgZmlsbD0iI2ZmZiIvPjwvc3ZnPgo="></span><span class="info">By continuing to browse the site you are agreeing to our use of cookies. <a href="http://company.bmj.com/privacy-policy/#cookies">Find out more here.</a></span></p> </section> <section class="advert"> <div id="oas_Top"> <script type="text/javascript">oas_tag.loadAd("Top");</script> </div> </section> <section class="nav-journals"> <a href="//journals.bmj.com/"><img src="//resources.bmj.com/repository/journals-network-project/images/wordpress/logo-bmj-journals.png" srcset="//resources.bmj.com/repository/journals-network-project/images/wordpress/logo-bmj-journals.svg"></a> <div class="menu-journals-menu-container"><ul id="menu-journals-menu" class="desktop menu"><li id="menu-item-69" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-69"><a href="http://bmj.com/?page_id=43">Subscribe</a></li> <li class="menu-item search-form"><form role="search" method="post" class="search-form" action="/search" id="highwire-search-quicksearch-form-1" accept-charset="UTF-8" ><input type="textbox" class="search-field" placeholder="search" value="" name="keywords" title="Search for:" ><input type="submit" class="search-submit" name="op" value="Search" ><input type="hidden" name="form_id" value="highwire_search_quicksearch_form_1" ><p class="advanced"><span><a href="/search"><span>Advanced</span> <span>search</span></a></span></p></form> </li><li class="menu-item search closed"><a href="#">Search <div class="svg-wrapper"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 48 48"><style>fill: #333; stroke: #333;</style><path d="M17.9 36.2C9.1 36.2 2 29.1 2 20.3S9.1 4.5 17.9 4.5s15.9 7.1 15.9 15.8S26.6 36.2 17.9 36.2zM17.9 6.5C10.2 6.5 4 12.7 4 20.3c0 7.6 6.2 13.8 13.9 13.8 7.7 0 13.9-6.2 13.9-13.8C31.8 12.7 25.5 6.5 17.9 6.5z"></path><polygon points="29.3 30.1 31.9 29.6 46 40.4 44.8 41.9 "></polygon><polygon points="29.3 30.1 29.5 32.7 43.6 43.5 44.8 41.9 "></polygon></svg></div></a></li></ul></div></section> <section class="nav-journal primary-color"> <div> <a href="/"><img id="journal-logo" src="//resources.bmj.com/repository/journals-network-project/images/journal-logos/logo-.png" srcset="//resources.bmj.com/repository/journals-network-project/images/journal-logos/logo-.svg"></a> <section class="nav-desktop"> <div class="journal-menu header-menu"><ul id="menu-journal-menu" class="menu"><li id="menu-item-46" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-46"><a href="//.bmj.com/content/early/recent">Online First</a></li> <li id="menu-item-47" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-47"><a href="//.bmj.com/content/current">Current Issue</a></li> <li id="menu-item-48" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-48"><a href="//.bmj.com/content/by/year">Archive</a></li> <li id="menu-item-49" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-49"><a href="http://bmj.com/?page_id=38">Authors</a></li> <li id="menu-item-50" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-50"><a href="http://bmj.com/?page_id=37">About</a></li> </ul></div></section> <section class="nav-mobile"> <ul> <li class="search closed"><img srcset="data:image/svg+xml;base64,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" src="//resources.bmj.com/repository/journals-network-project/images/wordpress/icon-search.png"></li><!-- --><li class="burger closed"><img srcset="data:image/svg+xml;base64,PHN2ZyB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciIHZpZXdCb3g9IjAgMCA0OCA0OCI+PHN0eWxlPi5he2ZpbGw6I2ZmZjt9PC9zdHlsZT48cmVjdCB4PSI4IiB5PSIxNC41IiB3aWR0aD0iMzIiIGhlaWdodD0iMyIgY2xhc3M9ImEiLz48cmVjdCB4PSI4IiB5PSIyMi41IiB3aWR0aD0iMzIiIGhlaWdodD0iMyIgY2xhc3M9ImEiLz48cmVjdCB4PSI4IiB5PSIzMC41IiB3aWR0aD0iMzIiIGhlaWdodD0iMyIgY2xhc3M9ImEiLz48L3N2Zz4K" src="//resources.bmj.com/repository/journals-network-project/images/wordpress/icon-hamburger-menu.png"></li> </ul> </section> </div> </section> <section class="nav-crumb"> <div> <div> <div class="crumbs"> </div> <div class="email"><a href="/alerts"><div class="svg-wrapper"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 33 22"> <style>.a{fill:none;}</style> <rect x="0.5" y="0.5" width="32" height="21" class="a"></rect> <polyline points="0.6 0.7 16.6 13.4 32.4 0.9 " class="a"></polyline> <line x1="0.8" y1="21.3" x2="11.6" y2="9.8" class="a"></line> <line x1="32.4" y1="21.5" x2="21.5" y2="9.7" style="fill:none;stroke-linejoin:round;"></line> </svg></div>Email alerts</a></div> </div> </div> </section> </header> <div id="signup-content" class="widecolumn"> <div class="mu_register wp-signup-container"> Registration has been disabled.</div> </div> <footer> <nav class="primary-color"> <div class="wrapper"> <div><div class="footer-menu-a footer-menu"><h3>Content</h3><ul id="menu-content" class="menu"><li id="menu-item-51" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-51"><a href="//.bmj.com/content/early/recent">Online First</a></li> <li id="menu-item-52" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-52"><a href="//.bmj.com/content/current">Current Issue</a></li> <li id="menu-item-53" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-53"><a href="//.bmj.com/content/by/year">Archive</a></li> <li id="menu-item-54" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-54"><a href="http://bmj.com/?page_id=41">Topic collections</a></li> <li id="menu-item-55" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-55"><a href="//.bmj.com/alerts/toc/edit?destination=">Sign up for email alerts</a></li> </ul></div></div><div><div class="footer-menu-b footer-menu"><h3>Journal</h3><ul id="menu-journal" class="menu"><li id="menu-item-56" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-56"><a href="http://bmj.com/?page_id=37">About</a></li> <li id="menu-item-57" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-57"><a href="http://bmj.com/?page_id=44">Editorial Board</a></li> <li id="menu-item-59" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-59"><a href="http://bmj.com/?page_id=45">Thank you to the reviewers</a></li> <li id="menu-item-61" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-61"><a href="http://bmj.com/?page_id=40">Most read</a></li> <li id="menu-item-64" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-64"><a href="http://bmj.com/?page_id=43">Your subscription options</a></li> </ul></div></div> </div><div class="wrapper"> <div><div class="footer-menu-c footer-menu"><h3>Authors</h3><ul id="menu-authors" class="menu"><li id="menu-item-58" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-58"><a href="http://bmj.com/?page_id=38">Instructions for authors</a></li> <li id="menu-item-60" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-60"><a href="http://mc.manuscriptcentral.com/">Submit a paper</a></li> <li id="menu-item-62" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-62"><a href="http://authors.bmj.com/open-access/">Open Access at BMJ</a></li> </ul></div></div><div><div class="footer-menu-d footer-menu"><h3>Help</h3><ul id="menu-help" class="menu"><li id="menu-item-63" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-63"><a href="http://bmj.com/?page_id=39">Contact us</a></li> <li id="menu-item-65" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-65"><a href="http://journals.bmj.com/cgi/reprintform">Reprints</a></li> <li id="menu-item-66" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-66"><a href="http://www.bmj.com/company/products-services/rights-and-licensing/permissions">Permissions</a></li> <li id="menu-item-67" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-67"><a href="http://www.bmj.com/company/contact-us/advertising-sponsorship/">Advertising</a></li> <li id="menu-item-68" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-68"><a href="http://myaccount.bmj.com/myaccount/customerservice/salesforce-form.html">Feedback form</a></li> </ul></div></div> </div> </nav> <section class="platform"> <div class="logo"> <a href="http://www.bmj.com/company"><img src="//resources.bmj.com/repository/journals-network-project/images/wordpress/logo-bmj-footer.png" srcset="//resources.bmj.com/repository/journals-network-project/images/wordpress/logo-bmj-footer.svg"></a> </div><div class="menu"> <ul> <li><a href="http://www.bmj.com/company/legal-information/">Website Terms &amp; Conditions</a></li> <li><a href="http://www.bmj.com/company/your-privacy/">Privacy &amp; Cookies</a></li> <li><a href="http://www.bmj.com/company/contact-us/">Contact BMJ</a></li> </ul> </div><div class="content"> <p></p> <p>Copyright &copy; 2017 . All rights reserved.</p> <p>京ICP备15042040号-3</p> </div> </section> <script type='text/javascript' src='http://bmj.com/wp-content/themes/jnp-base/js/feedbackify.js?ver=4.7.1'></script> <script type='text/javascript' src='http://bmj.com/wp-includes/js/wp-embed.min.js?ver=4.7.1'></script> </footer> </div> </body> </html>
rss
Arch Dis Child doi:10.1136/archdischild-2012-302983
  • Original article

The role of antibiotics in the treatment of acute rhinosinusitis in children: a systematic review

  1. Shakir Saeed
  1. Department of Paediatrics, Gwynedd Hospital, Betsi Cadwaladr University Health Board, Bangor, North Wales, UK
  1. Correspondence to Dr Michael John Cronin, Department of Paediatrics, Gwynedd Hospital, Betsi Cadwaladr University Health Board, Bangor, North Wales LL57 2PW, UK; michael.cronin2{at}wales.nhs.uk
  • Received 18 September 2012
  • Accepted 18 January 2013
  • Published Online First 16 February 2013

Abstract

Objective A systematic review of randomised controlled trials reporting the efficacy of antibiotics compared with placebo in the treatment of acute rhinosinusitis in children.

Design Systematic review and meta-analysis.

Data sources Cochrane Register of Controlled Trials, Medline, Embase and references obtained from retrieved articles.

Results Four studies fitted the selection criteria for inclusion. Risks for internal bias were thought to be small for each study, but external bias is potentially significant. The pooled OR for symptom improvement at 10–14 days favouring the use of antibiotics was 2.0 (95% CI 1.16 to 3.47; I2=14.8%).

Conclusions While the meta-analysis provides evidence to support the use of antibiotics for acute rhinosinusitis in children, it is the assessment of this review that such efficacy has not been adequately demonstrated. There remains a clear methodological challenge in the examination of this important clinical question; this challenge relates to difficulties in the application of appropriate diagnostic and inclusion criteria which are also consistent between studies.