Abstract
OBJECTIVE: To determine the efficacy of a short course of oral glucocorticoids in adult patients with acute rhinosinusitis. DESIGN: A double blind, placebo-controlled, randomized study conducted in 54 general practices in the Netherlands from December 2008 to March 2011 (NTR1295; http://www.trialregister.nl, search for 1295). METHOD: Adult patients with acute rhinosinusitis were randomly allocated to treatment with prednisolone 30 mg daily or placebo for 7 days. The primary outcome measure was the percentage of patients with resolution of facial pain or pressure on day 7. Secondary outcomes were time to recovery, median duration of symptoms, health-related quality of life, and reported side effects. RESULTS: 185 patients were randomized (prednisolone: n = 93; placebo: n = 92). Two participants withdrew from the study on day 1 and outcomes from 9 participants could not be included in the analysis because of incomplete data, leaving 174 patients (n = 88 and n = 86, respectively) eligible for intention-to-treat analyses. On day 7, 55/88 (62.5%) of patients in the prednisolone group and 48/86 (55.8%) in the placebo group had resolution of facial pain or pressure (difference: 6.7%; 95% CI: -7.9 to 21.2). There was no difference in the course of symptoms or health-related quality of life between groups. Side effects reported were mild and did not differ between groups. CONCLUSION: A short course of oral glucocorticoids seemed to have no clinically relevant beneficial effects in adult patients with acute rhinosinusitis.
