Azithromycin prophylaxis for preventing recurrent acute rhinosinusitis in children

Published online: April 21, 2017

Recurrent acute rhinosinusitis (RARS) is characterized by multiple episodes of acute rhinosinusitis (ARS) with symptoms and signs resolving completely between episodes. RARS has a considerable impact on quality of life and impairment of daily function. The role of antibiotic prophylaxis to prevent RARS in children has not been investigated.

In a recent study published in The Journal of Allergy and Clinical Immunology: In Practice, Veskitkul and colleagues conducted a 12-month prospective, randomized, double-blind, placebo-controlled study to determine the efficacy of azithromycin to prevent RARS in nonallergic rhinitis children (5-15 years). Azithromycin (5 mg/kg body weight/d) on 3 nonconsecutive days per week was assigned to the study group and a placebo was assigned to the control group.

After 12 months of intervention, the number of ARS episodes per year in the azithromycin group reduced significantly compared with the placebo group. The number needed to treat using azithromycin to prevent 1 patient suffering from RARS was 2. In addition, the average visual analog scale score and the average adjunctive medication score in the azithromycin group reduced significantly compared with the placebo group.

The researchers concluded that prophylactic use of azithromycin was beneficial in reducing the number of ARS episodes and medication score as well as improving nasal symptoms in nonallergic rhinitis children with RARS.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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