fluticasone and xylometazoline

Fluticasone propionate and nasal saline irrigation have been used in the treatment of sinonasal diseases for a long time. Our study investigates the effect of the combination of large volume low pressure nasal saline irrigation and fluticasone propionate for the treatment of pediatric acute rhinosinusitis.. Ninety-one pediatric patients with acute rhinosinusitis were included in our study. The patients were randomized into two groups. The first group (n=45) was treated with standard therapy (antibiotherapy+nasal decongestant) for 2 weeks, the second group was treated with the large volume low pressure nasal saline+fluticasone propionate combination for 3 weeks. The clinical scores, radiologic evaluations (X-ray Waters view), peak nasal inspiratory flow (PNIF) measurements, total symptom scores and hematologic parameters (WBC, CRP, ESR) of the patients were evaluated and compared.. There were no significant differences in between the two groups regarding age, gender, height and weight. Even though the clinical scores of Group 2 improved more rapidly, there were no significant differences in between groups regarding clinical scores by the 21st day. There were no significant differences in post treatment radiologic evaluations (Waters graphy). Both groups had significant improvement of their post treatment PNIF values, yet the improvement was more marked in Group 2 than in Group 1. The rhinorrhea, nasal congestion, throat itching and cough symptoms improved more rapidly in Group 2 than in Group 1. Post-treatment nose itching and sneezing symptoms were significantly less in Group 2. The values of hematologic parameters were significantly reduced at the end of the 3rd week in both groups.. Our study is a first in investigating the combined use of large volume low pressure nasal saline and fluticasone propionate in acute pediatric rhinosinusitis, and the results reveal that the combination therapy was effective. Low pressure large volume nasal saline+fluticasone propionate combination can be employed as a new line of therapy for the treatment of pediatric acute rhinosinusitis, either by itself or combined with standard therapy.

Topics: Acute Disease; Adolescent; Amoxicillin-Potassium Clavulanate Combination; Androstadienes; Anti-Inflammatory Agents; beta-Lactamase Inhibitors; Blood Sedimentation; C-Reactive Protein; Child; Combined Modality Therapy; Female; Fluticasone; Humans; Imidazoles; Inhalation; Male; Maxillary Sinus; Nasal Decongestants; Nasal Lavage; Prospective Studies; Radiography; Rhinitis; Sinusitis; Sodium Chloride

It is not known whether intranasal corticosteroids are beneficial to treat acute rhinosinusitis in patients with a history of chronic or recurrent sinus symptoms.. To assess whether the addition of an intranasal corticosteroid to antibiotic therapy affects the speed and rate of recovery of such patients with acute rhinosinusitis.. A double-blind, randomized, placebo-controlled multicenter trial of 95 patients (median age, 39 years) with a history of recurrent sinusitis or chronic rhinitis and evidence of acute infection by sinus radiograph or nasal endoscopy, which was conducted from October 1998 through April 2000 at 22 sites (12 primary care and 10 otolaryngology).. Two puffs (total dose, 200 microgram) of fluticasone propionate (n = 47) or placebo nasal spray (n = 48) in each nostril once daily for 21 days; all received 2 puffs of xylometazoline hydrochloride in each nostril twice daily for 3 days and 250 mg of cefuroxime axetil twice daily for 10 days.. Time to clinical success (patient reported cured or much improved) during telephone follow-up at 10, 21, and 56 days.. A total of 88 patients (93%) completed follow-up. Patients recorded their symptoms, work assessment, and compliance during the 3-week treatment phase. Patients receiving fluticasone achieved a significantly higher rate of clinical success than patients receiving placebo (93.5% vs 73.9%; P =.009). Patients treated with fluticasone improved significantly more rapidly (median of 6.0 days to clinical success) vs patients in the placebo group (median of 9.5 days; P =.01).. The addition of fluticasone to xylometazoline and antimicrobial therapy with cefuroxime improves clinical success rates and accelerates recovery of patients with a history of chronic rhinitis or recurrent sinusitis who present for treatment of acute rhinosinusitis.

Topics: Acute Disease; Administration, Intranasal; Adult; Androstadienes; Anti-Inflammatory Agents; Cefuroxime; Cephalosporins; Chronic Disease; Cost of Illness; Double-Blind Method; Drug Therapy, Combination; Female; Fluticasone; Glucocorticoids; Humans; Imidazoles; Male; Middle Aged; Nasal Decongestants; Proportional Hazards Models; Quality of Life; Rhinitis; Sinusitis

This study revealed that the nasal topical drops, which could be purchased without a proper prescription, should not be used randomly and non-selectively.. To investigate the effect of nasal drops and sprays on the nasal air flow and mucociliary transport time (MTT) in healthy volunteers with no septal deviation and no history of frequent upper respiratory infection.. Saline, fluticasone propionate drops and sprays, mometasone furoate, budesonide, xylometasoline chloride, fusafungine spray, Ringer's lactate and sea water were selected as the agents to be investigated. Volunteers were subdivided into two subgroups according to their rhinomanometric scores: group 1 consisted of subjects with nasal respiration > or =500 ml at 150 daPa and group 2 consisted of those with nasal air flow <500 ml.. No statistically significant difference was found among the effects of these agents on MTT in group 1. In group 2, xylometasoline chloride, fluticasone propionate spray and sea water sprays prolonged the MTT. When the rhinomanometric scores at 150 daPa were assessed, use of xylometasoline chloride, fluticasone propionate drops, budesonide, fusafungine, sea water and Ringer's lactate were found to diminish the nasal air flow with respect to normal values in group 1. In group 2, no significant difference was noticed between normal values and values acquired after use of nasal drops. Comparing the same agents, we did not find a significant difference between groups 1 and 2 regarding MTT and nasal air flow.

Topics: Administration, Intranasal; Adult; Aerosols; Androstadienes; Anti-Bacterial Agents; Anti-Inflammatory Agents; Budesonide; Depsipeptides; Female; Fluticasone; Fusarium; Humans; Imidazoles; Isotonic Solutions; Male; Mometasone Furoate; Mucociliary Clearance; Nasal Decongestants; Nasal Mucosa; Nonprescription Drugs; Pregnadienediols; Pulmonary Ventilation; Rhinomanometry; Ringer's Lactate; Seawater; Sodium Chloride; Solutions; Young Adult