Although corticosteroid sprays are undoubtedly helpful in the treatment of many cases of acute rhinosinusitis, one should not prescribe these drugs cavalierly. Although absorption is minuscule, and they are generally very well tolerated, there is the cost issue. And there is always the possibility of unexpected consequences with large-scale use, said Dr. Citardi.
Explore This IssueMay 2008
Experts Assess the Review
So how do the experts assess the review? Dr. Citardi found its conclusions intriguing, and said that they confirm his anecdotal experience, in which patients reported that the topical nasal steroid sprays have seemed to reduce symptoms of the common cold. But, in the end, the reported advantage remains relatively small.
Dr. Ferguson also found that the study validated her experience, but she looks forward to reviews that will include newer and better studies being conducted now. She also pointed out a fundamental problem in assessment: The studies in the review defined acute as a condition lasting under 8 weeks, whereas the standard definition for American otolaryngologists is under 4 weeks.
Dr. Kountakis also pointed to newer studies in the field, and said that he finds the topical corticosteroids useful in practice, but the literature can’t make a compelling argument that [the sprays] are greatly beneficial in acute rhinosinusitis. As such, the review is not a tremendous breakthrough.
Dr. Marple found that the review confirmed his own observations. He likes the efficacy of the steroid sprays and their applicability in a wide range of cases. And the review underscored the treatment’s safety, which, he said, is their strong suit. As for the cost issue, they’re expensive-but so are antibiotics, which appear less likely to offer the patient relief.
©2008 The Triological Society