바이러스성, 세균성 급성 부비동염 환자에서 단기간 비강내 분무 스테로이드 사용은 작은 증상 이득과 미미한 부작용을 나타냈습니다. 비강내 분무 스테로이드는 알레르기 비염이 있는 환자에서 가장 이득이 있는 것 같습니다. 이론적 작용 기전은 점막 염증 감소로 인한 개선된 sinus drainage입니다. 항생제에 부가하여 사용할 때 위약-대조 연구들의 메타분석에서 1명의 임상적 증상 개선 위해 필요한 비강내 분무 스테로이드 치료 환자 수는 15명이었습니다.
Studies have shown small symptomatic benefits and minimal adverse effects with short-term use of intranasal glucocorticoids for patients with both viral and bacterial ARS. Intranasal glucocorticoids are likely to be most beneficial for patients with underlying allergic rhinitis. The theoretic mechanism of action is a decrease in mucosal inflammation that allows improved sinus drainage.
A meta-analysis of three studies involving patients with ARS diagnosed by symptoms and confirmed by radiologic or endoscopic studies found that use of intranasal steroids increased the rate of symptom response compared with placebo (risk ratio 1.11, 95% CI 1.04-1.18). A higher dose of intranasal glucocorticoids had a stronger effect on symptom improvement. When used as an adjunct to antibiotic therapy in the treatment of ABRS, a meta-analysis of placebo-controlled trials suggests that 15 patients would need to be treated with intranasal glucocorticoids to improve clinical symptoms in one patient.
REF. UpToDate 2019.06.18
