抗生素在儿童鼻窦炎治疗中的地位

doi:10.6040/j.issn.1673-3770.1.2019.056

摘要/Abstract

摘要： 儿童时期患病毒性上呼吸道感染容易导致鼻窦炎发病率高且易反复发作,是常见病之一。抗生素在以往的中外鼻窦炎诊疗指南中,均被放到一线治疗地位。然而儿童与成人在解剖学、病理生理过程以及伴发疾病等各因素的比较上均存在明显差异,因此近年在儿童鼻窦炎的诊疗过程中抗生素是否属于一线治疗一直存在争议。现回顾国内外文献,对抗生素治疗儿童鼻窦炎的作用进行讨论。

关键词: 儿童, 鼻窦炎, 抗生素

Abstract: Pediatric sinusitis is one of the most common childhood diseases. Recurrent upper respiratory infections are associated with its high incidence and relapse rates, which increases the burden on families and society. In the past, the use of antibiotics has been advised in Chinese and foreign guidelines for the treatment of sinusitis as the first-line response. However, differences between children and adults in anatomy, pathophysiology, and associated diseases have led to controversy regarding antibiotic treatment for pediatric sinusitis. Further, in recent years, there have been debates about the use of antibiotics as the first-line therapy. This paper reviews the efficacy of antibiotics in the treatment of pediatric sinusitis.

Key words: Pediatric, Sinusitis, Antibiotics

中图分类号:

R765

李勇. 抗生素在儿童鼻窦炎治疗中的地位[J]. 山东大学耳鼻喉眼学报, 2019, 33(6): 20-24.

LI Yong. The role of antibiotics for pediatric sinusitis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(6): 20-24.

参考文献

[1] Fokkens W, Lund V, Mullol J, et al. EP3OS 2007: European position paper on rhinosinusitis and nasal polyps 2007. A summary for otorhinolaryngologists[J]. Rhinology, 2007, 45(2): 97-101.
[2] Fokkens WJ, Lund VJ, Mullol J, et al. EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists[J]. Rhinology, 2012, 50(1): 1-12. doi: 10.4193/Rhino50E2.
[3] 中华耳鼻咽喉头颈外科杂志编辑委员会. 儿童鼻窦炎诊断和治疗建议(2012年,昆明)[J]. 中华耳鼻咽喉头颈外科杂志, 2013, 48(3): 177-179. Chinese Journal of Otorhinolaryngology Head and Neck Surgery. Recommendations for diagnosis and treatment of rhinosinusitis in children(2012, kunming)[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2013, 48(3): 177-179.
[4] 中华医学会耳鼻咽喉头颈外科学分会鼻科学组. 中国慢性鼻窦炎诊断和治疗指南(2018)[J]. 中华耳鼻咽喉头颈外科杂志, 2019, 54(2), 89-100. Chinese medical association Nasal science group. Chinese guidelines for diagnosis and treatment of chronic sinusitis(2018)[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2019, 54(2), 89-100.
[5] Shahid SK. Phimosis in children[J]. ISRN Urol, 2012, 2012: 707329. doi: 10.5402/2012/707329.
[6] Heath J, Hartzell L, Putt C, et al. Chronic rhinosinusitis in children: pathophysiology, evaluation, and medical management[J]. Curr Allergy Asthma Rep, 2018, 18(7): 37. doi: 10.1007/s11882-018-0792-8.
[7] Ramadan HH. Revision endoscopic sinus surgery in children: surgical causes of failure[J]. Laryngoscope, 2009, 119(6): 1214-1217. doi: 10.1002/lary. 20230.
[8] Rosenfeld RM. Pilot study of outcomes in pediatric rhinosinusitis[J]. Arch Otolaryngol Head Neck Surg, 1995, 121(7): 729-736. doi: 10.1001/archotol. 1995. 01890070015005.
[9] Zuliani G, Carron M, Gurrola J, et al. Identification of adenoid biofilms in chronic rhinosinusitis[J]. Int J Pediatr Otorhinolaryngol, 2006, 70(9): 1613-1617. doi: 10.1016/j.ijporl. 2006. 05. 002.
[10] Soler ZM, Rosenbloom JS, Skarada D, et al. Prospective, multicenter evaluation of balloon sinus dilation for treatment of pediatric chronic rhinosinusitis[J]. Int Forum Allergy Rhinol, 2017, 7(3): 221-229. doi: 10.1002/alr. 21889.
[11] Steinke JW, Bradley D, Arango P, et al. Cysteinyl leukotriene expression in chronic hyperplastic sinusitis-nasal polyposis: importance to eosinophilia and asthma[J]. J Allergy Clin Immunol, 2003, 111(2): 342-349. doi: 10.1067/mai. 2003.67.
[12] Chan KH, Abzug MJ, Coffinet L, et al. Chronic rhinosinusitis in young children differs from adults: a histopathology study[J]. J Pediatr, 2004, 144(2): 206-212. doi: 10.1016/j.jpeds. 2003.11.009.
[13] Berger G, Kogan T, Paker M, et al. Pediatric chronic rhinosinusitis histopathology: differences and similarities with the adult form[J]. Otolaryngol Head Neck Surg. 2011 Jan;144(1):85-90. doi: 10.1177/0194599810390443.
[14] Steinke JW, Borish L. The role of allergy in chronic rhinosinusitis[J]. Immunol Allergy Clin North Am, 2004, 24(1): 45-57. doi: 10.1016/S0889-8561(03)00108-5.
[15] Kennedy JL, Borish L. Chronic sinusitis pathophysiology: the role of allergy[J]. Am J Rhinol Allergy, 2013, 27(5): 367-371. doi: 10.2500/ajra.2013.27. 3906.
[16] Wald ER, Chiponis D, Ledesma-Medina J. Comparative effectiveness of amoxicillin and amoxicillin-clavulanate potassium in acute paranasal sinus infections in children: a double-blind, placebo-controlled trial[J]. Pediatrics, 1986, 77(6): 795-800.
[17] Lindbaek M, Hjortdahl P, Johnsen UL. Randomised, double blind, placebo controlled trial of penicillin V and amoxycillin in treatment of acute sinus infections in adults[J]. BMJ, 1996, 313(7053): 325-329. doi: 10.1136/bmj.313. 7053.325.
[18] van Buchem FL, Knottnerus JA, Schrijnemaekers VJ, et al. Primary-care-based randomised placebo-controlled trial of antibiotic treatment in acute maxillary sinusitis[J]. Lancet, 1997, 349(9053): 683-687. doi: 10.1016/s0140-6736(96)07585-x.
[19] Wald ER, Nash D, Eickhoff J. Effectiveness of amoxicillin/clavulanate potassium in the treatment of acute bacterial sinusitis in children[J]. Pediatrics, 2009, 124(1): 9-15. doi: 10.1542/peds. 2008-2902.
[20] Chow AW, Benninger MS, Brook I, et al. IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adults[J]. Clin Infect Dis, 2012, 54(8): e72-e112. doi: 10.1093/cid/cir1043.
[21] Garbutt JM, Goldstein M, Gellman E, et al. A randomized, placebo-controlled trial of antimicrobial treatment for children with clinically diagnosed acute sinusitis[J]. Pediatrics, 2001, 107(4): 619-625. doi:10.1542/peds. 107.4.619.
[22] De Sutter AI, De Meyere MJ, Christiaens TC, et al. Does amoxicillin improve outcomes in patients with purulent rhinorrhea? A pragmatic randomized double-blind controlled trial in family practice[J]. J Fam Pract, 2002, 51(4): 317-323.
[23] Varonen H, Kunnamo I, Savolainen S, et al. Treatment of acute rhinosinusitis diagnosed by clinical criteria or ultrasound in primary care. A placebo-controlled randomised trial[J]. Scand J Prim Health Care, 2003, 21(2): 121-126.
[24] Fokkens W, Lund V, Mullol J, et al. EP3OS 2007: European position paper on rhinosinusitis and nasal polyps 2007. A summary for otorhinolaryngologists[J]. Rhinology, 2007, 45(2): 97-101.
[25] Bhattacharyya N. The role of infection in chronic rhinosinusitis[J]. Curr Allergy Asthma Rep, 2002, 2(6): 500-506. doi: 10.1007/s11882-002-0091-1.
[26] Bhattacharyya N. Bacterial infection in chronic rhinosinusitis: a controlled paired analysis[J]. Am J Rhinol, 2005, 19(6): 544-548.
[27] Ragab SM, Lund VJ, Scadding G. Evaluation of the medical and surgical treatment of chronic rhinosinusitis: a prospective, randomised, controlled trial[J]. Laryngoscope, 2004, 114(5): 923-930. doi: 10.1097/00005537-200405000-00027.
[28] Videler WJ, Badia L, Harvey RJ, et al. Lack of efficacy of long-term, low-dose azithromycin in chronic rhinosinusitis: a randomized controlled trial[J]. Allergy, 2011, 66(11): 1457-1468. doi:10.1111/j.1398-9995. 2011.02693.x.
[29] Brietzke SE, Shin JJ, Choi S, et al. Clinical consensus statement: pediatric chronic rhinosinusitis[J]. Otolaryngol Head Neck Surg, 2014,151(4):542-553. doi: 10.1177/0194599814549302.
[30] Cain RB, Lal D. Update on the management of chronic rhinosinusitis[J]. Infect Drug Resist, 2013, 6: 1-14. doi: 10.2147/IDR. S26134.
[31] Jervis-Bardy J, Boase S, Psaltis A, et al. A randomized trial of mupirocin sinonasal rinses versus saline in surgically recalcitrant staphylococcal chronic rhinosinusitis[J]. Laryngoscope, 2012, 122(10): 2148-2153. doi: 10.1002/lary. 23486.
[32] Whatley WS, Chandra RK, MacDonald CB. Systemic absorption of gentamicin nasal irrigations[J]. Am J Rhinol, 2006, 20(3): 251-254. doi: 10.2500/ajr.2006.20. 2855.
[33] Otten HW, Antvelink JB, Ruyter de Wildt H, et al. Is antibiotic treatment of chronic sinusitis effective in children?[J]. Clin Otolaryngol Allied Sci, 1994, 19(3): 215-217. doi: 10.1111/j.1365-2273.1994. tb01217.x.

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