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Steriods ‘effective for three weeks’ in sinusitis

Intranasal corticosteroids are effective in reducing symptoms of acute sinusitis short-term, say the authors of a UK analysis.

The authors looked at six randomised controlled trials, which included a total of 2,495 patients recruited from outpatient settings in the UK, Turkey and the US. They compared data for intranasal corticosteroids use with placebo in children or adults with signs and symptoms of acute sinusitis.

They found those on intranasal steroids were 8% more likely to experience improvement or resolution of symptoms after 14 to 21 days of therapy than those on placebo.

When they analysed the timing of this outcome, they found that value improved to 11% likelihood of improvement or resolution at 21 days, compared with a drop to 5% at 14 to 15 days.

They also found symptom resolution or improvement was affected by the dose, with analyses of trials using mometasone furoate spray showing a significant dose-response relationship. Patients receiving 800 micrograms were 12% more likely to experience improvement or resolution, whereas those on 400 micrograms were only 7% likely.

Study lead Dr Gail Hayward, professor at the department of primary care health sciences at the University of Oxford, said: ‘On the basis of our review, when intranasal corticosteroids are used, we recommend doses of 800 micrograms of mometasone furoate daily.'

Annals of Family Medicine 2012; 10: 241-249