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Steroid nasal sprays show small benefit for sinusitis: study by 123wert sdfsf
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Steroid nasal sprays show small benefit for sinusitis: study |
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They eased symptoms only after three weeks, taken at high doses. By Alan Mozes HealthDay Reporter TUESDAY, May 15 (HealthDay News) -- Corticosteroid nasal spraysapparently are not a silver bullet when it comes to symptom relieffor acute sinusitis patients, a new review suggests. The British analysis of six prior studies found that the spraysconfer only a small degree of benefit, and only after being takenfor three weeks at relatively high doses. The disappointing observation comes amid growing public healthconcerns that the more common use of antibiotics for short-termsinusitis symptoms is both ineffective and potentially dangerousbecause the drugs contribute to bacterial resistance. "Looking at all the trials together, we found that nasal steroidsseem to give a small benefit for patients with acute sinusitis,"said study co-author Matthew Thompson, a senior clinical scientistin the department of primary care health sciences at the Universityof Oxford, in England.
"In fact, they work about as well asantibiotics do." "When we compared patients who were given steroid nasal spray withthose who were given an [inactive] spray, we found that patientsgiven the steroid spray got better faster," he added. "However,although we see this effect after taking the spray for 14 days, thebig difference only occurs at 21 days. We also found that a largerdose of the nasal steroids worked better than a lower dose." Thompson and his colleagues discuss their observations in theMay/June issue of the journal Annals of Family Medicine . Although chronic sinusitis cases (driven by fungal exposure,bacterial infection, or anatomical complications such as polyps ora deviated nasal septum) can endure well beyond the three-monthmark, short-term (acute) sinusitis typically lasts just a fewweeks. Thompson pointed out, however, that such acute cases (typified bycold-like symptoms such as a congested or runny nose, accompaniedby face pain) send about 31 million Americans to the doctor everyyear.
Although the condition usually resolves itself without seriouscomplications, doctors have few tools to address the pain andmisery that can afflict patients while the sinusitis runs itscourse. Antibiotics are the standard first-line treatment, given to almost90 percent of patients. But the study authors pointed out that onlyone in 15 patients seem to get any benefit from the approach. On the other hand, steroid sprays have been cited as helpful in thetreatment of a range of respiratory illnesses among both childrenand adults. Enter the Oxford team, which set out to analyze the findings of sixacute sinusitis studies conducted through early 2011 in the UnitedStates, the United Kingdom and Turkey.
In all, the studies involved nearly 2,500 acute sinusitis patients,both children and adults. No chronic sinusitis patients wereincluded, and all studies explored the potential benefit of threetypes of corticosteroid nasal sprays: budesonide (Rhinocort),fluticasone propionate (Flonase, Flovent) and mometasone furoate(Nasonex). In five of the studies, antibiotics also wereprescribed. The bottom-line: The analysis revealed that the nasal spraysappeared to provide a "small but significant benefit" within two tothree weeks of treatment. Facial pain and nasal congestion were the two symptoms cited asbeing most responsive to spray treatment.
And, in that respect,more was more: Higher doses and longer treatment plans (thoselasting three weeks) seemed to provide the greatest relief. The team was somewhat tepid on the degree of benefit, however,noting that two-thirds of the patients saw their symptoms improveor disappear altogether within two to three weeks after taking"dummy" sprays with no corticosteroid in them. Taking the actualnasal spray appeared to help only 7 percent more patients, theresearchers noted. Thompson said the findings suggest that, although nasal sprays are"not a game changer," they may offer a treatment alternative. But Dr.
John Hickner, chairman of the department of family medicineat the Cleveland Clinic Lerner College of Medicine at Case WesternReserve University School of Medicine in Cleveland, was notimpressed. In an editorial accompanying the study, Hickner said such spraysare of "minimal value" for sinusitis patients. "Nasal steroids are great for nasal allergies," he noted. "For hayfever, for example, but not for acute sinusitis. The study ofprevious studies shows that they work a little but not that muchand not right away, which is what patients want.
And they costabout $60 for a bottle, so you just don't get a lot of bang foryour buck." "I would say the best thing for these patients to do is to takezinc," Hickner said. "Zinc studies are pretty reliable, and theysuggest that taking zinc lozenges for five days might reducesymptoms for one to two days, and they might not get so severe. Andperhaps take some ibuprofen and Sudafed (pseudoephedrine) as adecongestant. All of that is much cheaper and probably just aseffective." More information For more on sinusitis, visit the U.S. National Library of Medicine.
SOURCES: Matthew Thompson, senior clinical scientist, department ofprimary care health sciences, University of Oxford, England; JohnHickner, M.D., MSc, chairman, department of family medicine,Cleveland Clinic Lerner College of Medicine, Case Western ReserveUniversity School of Medicine, Cleveland; May/June 2012 Annals of Family Medicine Copyright © 2012 HealthDay . All rights reserved. I am an expert from Home Storage & Organization, usually analyzes all kind of industries situation, such as razor pocket bike , giovanni dirt bike.
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