Ann Robinson’s research reviews—3 August 2023

S’not what it seemsCan you tell which snotty-nosed children have acute sinusitis rather than a cold or hayfever? If you diagnose acute sinusitis, do you prescribe antibiotics? And is the colour of their snot a factor in your decision?This useful US primary care study of 515 children aged 2-11 years diagnosed with acute sinusitis based on clinical criteria found a large overlap in symptoms with viral upper respiratory tract infections (no surprise there). Researchers found that 28% of children didn’t grow any pathogenic bacteria from their nasopharynx. The children given antibiotics (amoxicillin and clavulanate for 10 days) had milder illness (mean symptom scores 9 v 10.6) and got better quicker (seven v nine days) than those given placebo. However, antibiotics had only minimal benefit in the 28% of children who didn’t have any bacterial colonisation of their nasopharynx. And kids with yellow or green snot were no more likely to…
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