Similar effect of therapeutic ultrasound and antibiotics for acute bacterial rhinosinusitis: a randomised trial.
OBJECTIVE
Is there any difference between the effect of therapeutic ultrasound and antibiotics (amoxicillin) on pain and congestion for acute bacterial rhinosinusitis in the short-term? Is there any difference in patient satisfaction, preferred future intervention, side-effects and relapses in the long-term?


METHODS
A randomised trial with concealed allocation and intention-to-treat analysis.


METHODS
48 patients (6 dropouts) with clinically diagnosed acute bacterial rhinosinusitis in primary care.


METHODS
The experimental group received 4 consecutive days of ultrasound and the control group received a 10-day course of antibiotics.


METHODS
Pain and congestion around the nose and in the forehead and teeth were measured on a 0-10 numeric rating scale at baseline, Day 4, and Day 21. Satisfaction, preferred future intervention, side-effects, and relapses were measured one year later.


RESULTS
By Day 4, pain around the nose had decreased by 1.5 points out of 10 (95% CI 0.6 to 2.5) more in the experimental group than the control group. There were no other differences in decrease in pain and congestion between the groups at Day 4 or 21. At one year follow-up, the experimental group were more likely to prefer ultrasound than the control group were to prefer antibiotics to manage a future episode (RR 2.75, 95% CI 1.19 to 7.91). There were no other differences between the groups in terms of satisfaction with intervention, number of side-effects, or number of relapses.


CONCLUSIONS
The results of this study suggest that therapeutic ultrasound is a viable alternative to antibiotics in the management of acute bacterial rhinosinusitis.


BACKGROUND
NCT00934830.
Høsøien
Eli
E
Physiotherapy Private Practice, Roros, Norway.
Lund
Anne B
AB
Vasseljen
Ottar
O
D000208:Acute Disease; D000328:Adult; D000658:Amoxicillin / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction; D009664:Norway; D010147:Pain Measurement; D011320:Primary Health Care; D012220:Rhinitis / Q000188:drug therapy / Q000382:microbiology / Q000628:therapy*; D012852:Sinusitis / Q000188:drug therapy / Q000382:microbiology / Q000628:therapy*; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000379:methods*
D000900:Anti-Bacterial Agents; D000658:Amoxicillin