Decongestants, antihistamines and nasal irrigation for acute sinusitis in children

Young children experience an average of six to eight colds per year. Of every 10 children with a cold, one develops sinusitis. Sinusitis occurs when the sinuses, which do not drain properly during a cold, become secondarily infected with bacteria. Instead of getting better, children with sinusitis often have worsening or persistent cold symptoms. In order to alleviate the symptoms of sinusitis, parents and physicians often resort to using decongestants, antihistamines and nasal irrigation. These treatments are available without requiring a prescription and are widely used. Previous studies have shown that the use of antihistamines and decongestants in children is associated with significant side effects. The goal of this review was to determine whether there is any evidence in the medical literature for or against the use of these interventions in children with sinusitis. After a comprehensive review of the literature, we failed to find any trials that evaluated the efficacy of these interventions (compared to no medication or placebo) in children with clinically diagnosed acute sinusitis. Accordingly, the use of antihistamines and decongestants in children with acute sinusitis cannot be recommended.