Adenoiditis medical therapy
The mainstay of therapy for adenoiditis is symptomatic therapy. Pharmacologic medical therapy is recommended among patients with recurrent and chronic adenoiditis. The best antibiotic therapy regimen include amoxicillin - clavulanic acid or a cephalosporin.
- There are no proven evidence of medical therapy effectiveness in recurrent or chronic adenoiditis cases.
- Systemic oral antibiotics can be used if the suspected organism is a bacteria and should be prescribed for a long-term (i.e. 6 wk) for lymphoid tissue infection.
- The most appropriate antibiotics are amoxicillin - clavulanic acid or a cephalosporin.
- Cephalosporins and macrolides are considered good alternatives to penicillin in the acute setting.
- A macrolide such as erythromycin is indicated for patients allergic to penicillin.
- Although antibiotic therapy can treat acute adenoiditis, it usually fails to eradicate the bacteria in chronic or recurrent adenoiditis.
- Nowadays with the current trend of resistant bacteria, the use of prophylactic or long-term antibiotics has been decreased.
Symptomatic Treatment and Pain Management
- Topical therapy:
- Topical nasal steroids in children can be used to treat adenoid hypertrophy.
- Topical nasal steroids can lead to adenoid shrinkage slightly (ie, up to 10%), which may help relieve some nasal obstruction symptoms. However, it is not a permanent therapy and all symptoms may raise again after discontinuation of topical nasal steroid.
- A combination trial of topical nasal steroid spray and saline spray may be considered for effective control of symptoms in children.
- In cases of viral adenoiditis, treatment with analgesics or antipyretics is often sufficient.
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