Acute Respiratory Infection, Sinusitis
Conditions
Keywords
respiratory infection, sinusitis, rhinosinusitis, children, middle meatal specimens, respiratory track bacteria, amoxicillin-clavulanate, pneumococci, haemophilus, moraxella
Brief summary
The purpose of this study is to find out whether the children with respiratory infection and the presence of pathogenic bacteria (S. pneumoniae, H. influenzae or M. catarrhalis) in the nasal middle meatus benefit from antimicrobial treatment.
Detailed description
Acute sinusitis is one of the most common disease in children requiring antimicrobial treatment. The diagnosis and treatment outcomes of acute sinusitis are contradictory, and better diagnostic criteria are needed. In adults with acute maxillary sinusitis, bacterial culture results obtained from the nasal middle meatus are comparable to those obtained from sinus puncture and aspiration. In children, the presence of pathogenic bacteria (S. pneumoniae, H. influenzae or M. catarrhalis) in the nasal middle meatus during respiratory infection predicts longer duration of signs and symptoms of common cold. In this randomized placebo-controlled study, the effect of the antimicrobial treatment (amoxicillin-clavulanate) is examined in children with pathogenic bacteria (S. pneumoniae, H. influenzae or M. catarrhalis) in the nasal middle meatus during respiratory infection. The duration of the symptoms and speed of recovery is recognized by daily symptom-diary, the results are compared between the treatment groups.
Interventions
DRUGamoxicillin clavulanate acid
mixture 0.28125 ml / kg twice a day for 7 days
DRUGplacebo
mixture, 0.28125 ml/kg twice a day for 7 days
Sponsors
Oulu University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
6 Years to 13 Years
Healthy volunteers
No
Inclusion criteria
* acute respiratory infection with nasal symptoms (nasal obstruction or discharge) * seeking medical help from health centre for the respiratory symptoms * pathogenic bacteria (S pneumoniae, H influenzae or M catarrhalis) identified from right or left nasal middle meatus in the endoscopically taken swab culture sampling taken by a study investigator (all microbiological analyses are done by the National Public Health Institute´s microbiological laboratory in Oulu)
Exclusion criteria
* otitis, tonsillitis or other disease requiring antimicrobial treatment * respiratory infection within 4 weeks of screening * antimicrobial treatment within 4 weeks of screening * allergy to penicillin or amoxicillin
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Duration of continuous daily symptoms of the acute respiratory infection diagnosed at the study entry. | within the first 3 weeks after enrolment |
Secondary
| Measure | Time frame |
|---|---|
| duration (days)and severity (grade mild, severe) of different symptoms (clear nasal discharge, coloured nasal discharge, nasal obstruction, cough, throat pain, ear ache, fever, headache, diarrhea) | within the first three weeks after enrolment |
| number of days the child is using the following symptomatic drugs (pain killers, nasal vasoconstrictors, nasal corticosteroids, asthma drugs, antihistamines) | within the first three weeks after the enrolment |
| number of days the child is not at school and that the parents are not at work | within the first three weeks after enrolment |
Countries
Finland
Contacts
Primary ContactAila A Kristo, MD
Backup ContactOlli-Pekka Alho, MD
Outcome results
None listed