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Table 10 Summary of the evidence for ‘efficacy of systemic steroids in pediatric sinonasal disease’

From: Benefits and harm of systemic steroids for short- and long-term use in rhinitis and rhinosinusitis: an EAACI position paper

Study Year LOE (1a to 5) Study design Study groups Clinical end-point efficacy Conclusion
Ozturk et al. 2011 1b RCT 1. Children with CRSsNP (6–17 years) receiving antibiotics and methylprednisolone 1 mg/kg and reduced progressively over a 15-day treatment course
2. Children with CRSsNP receiving antibiotics and placebo
1. Change in mean symptom and CT scores pre- and post-treatment
2. Change in individual symptom scores, relapse rate
Beneficial effect of MP in combination with antibiotics on mean symptoms, CT scores, VAS for cough, nasal obstruction and post-nasal drainage. No difference in relapse rate
Scorpinski et al. 2008 3b Retro-spective uncontrolled 1741 children with CRS treated with antibiotics, intranasal topical corticosteroids and oral corticosteroids (> 4 days) or combination CT scores Improvement of CT scores after oral corticosteroid treatment, in mono- or pluritherapy
Tosca et al. 2003 4 Uncontrolled prospective cohort study 30 asthmatic CRS children treated with antibiotics, intranasal steroids and a short course of deflazacort (1 mg/kg daily for 2 days, 0.5 mg/kg daily for 4 days and 0.25 mg/kg daily for 4 days) Nasal endoscopy and cytokine patterns in nasal lavages Resolving of purulent discharge after combination treatment and decrease of mean IL4-levels in nasal lavage
  1. RCT randomized controlled trial, CR chronic rhinosinusitis, CRSsNP chronic rhinosinusitis without nasal polyps, CRS chronic rhinosinusitis. CRSwNP chronic rhinosinusitis with nasal polyps, MP methylprednisolone