title: Decongestants, antihistamines and nasal irrigation for acute sinusitis in children.
abstract: BACKGROUND
  The efficacy of decongestants, antihistamines and nasal irrigation in children with clinically diagnosed acute sinusitis has not been systematically evaluated.
  
  
  OBJECTIVE
  To systematically review the efficacy of decongestants, antihistamines and nasal irrigation in children with clinically diagnosed acute sinusitis. We considered the following four interventions: 1) decongestants versus placebo or no medication, 2) antihistamines versus placebo or no medication, 3) decongestant and antihistamine combination versus placebo or no medication, 4) nasal irrigation versus no irrigation. The primary outcomes of the review were symptom resolution (improvement in symptom score from enrolment to day 5) and overall symptom burden (as measured by average symptom scores while on therapy).
  
  
  METHODS
  We searched the Cochrane Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 2, 2010), which includes the Acute Respiratory Infections Group's Specialized Register, MEDLINE (1950 to May Week 1, 2010) and EMBASE (1950 to January 2010).
  
  
  METHODS
  We included randomized controlled trials (RCTs) and quasi-RCTs which evaluated children less than 18 years of age with acute sinusitis, defined as 10 to 30 days of rhinorrhea, congestion or daytime cough. We excluded trials of children with chronic sinusitis and allergic rhinitis.
  
  
  METHODS
  Two review authors independently assessed each study for inclusion.
  
  
  RESULTS
  Of the 402 studies found through the electronic searches and handsearching, none met all the inclusion criteria.
  
  
  CONCLUSIONS
  There is no evidence to determine whether the use of antihistamines, decongestants or nasal irrigation is efficacious in children with acute sinusitis. Further research is needed to determine whether these interventions are beneficial in the treatment of children with acute sinusitis.
authors.affiliation: General Academic Pediatrics, Children's Hospital of Pittsburgh, 3414 Fifth Ave, Suite 301, Pittsburgh, PA, USA, 15213.
authors.forename: Nader
authors.initials: N
authors.lastname: Shaikh
authors.forename: Ellen R
authors.initials: ER
authors.lastname: Wald
authors.forename: Mina
authors.initials: M
authors.lastname: Pi
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D002648:Child; D003131:Combined Modality Therapy / Q000379:methods; D006633:Histamine Antagonists / Q000627:therapeutic use*; D006801:Humans; D014663:Nasal Decongestants / Q000627:therapeutic use*; D055556:Nasal Lavage; D012852:Sinusitis / Q000628:therapy*
chemical_list: D006633:Histamine Antagonists; D014663:Nasal Decongestants