Adenoiditis medical therapy: Difference between revisions
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==Overview== | ==Overview== | ||
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]]. | |||
== Medical Therapy == | |||
=== Antibiotic therapy === | |||
*There are no proven evidence of medical therapy effectiveness in recurrent or chronic [[adenoiditis]] cases.<ref name="pmid12117336">{{cite journal |vauthors=Havas T, Lowinger D |title=Obstructive adenoid tissue: an indication for powered-shaver adenoidectomy |journal=Arch. Otolaryngol. Head Neck Surg. |volume=128 |issue=7 |pages=789–91 |year=2002 |pmid=12117336 |doi= |url=}}</ref> | |||
*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.<ref>Casey JR, Pichichero ME. Meta-analysis of cephalosporin versus penicillin treatment of group A streptococcal tonsillopharyngitis in children. Pediatrics 2004;113:866-882.</ref> | |||
*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.<ref name="pmid11686429">{{cite journal |vauthors=Huang SW, Giannoni C |title=The risk of adenoid hypertrophy in children with allergic rhinitis |journal=Ann. Allergy Asthma Immunol. |volume=87 |issue=4 |pages=350–5 |year=2001 |pmid=11686429 |doi=10.1016/S1081-1206(10)62251-X |url=}}</ref> | |||
*Nowadays with the current trend of resistant bacteria, the use of prophylactic or long-term antibiotics has been decreased.<ref name="pmid22339566">{{cite journal |vauthors=Karlıdağ T, Bulut Y, Keleş E, Alpay HC, Seyrek A, Orhan İ, Karlıdağ GE, Kaygusuz İ |title=Presence of herpesviruses in adenoid tissues of children with adenoid hypertrophy and chronic adenoiditis |journal=Kulak Burun Bogaz Ihtis Derg |volume=22 |issue=1 |pages=32–7 |year=2012 |pmid=22339566 |doi= |url=}}</ref> | |||
===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 [[analgesic]]s or [[antipyretic]]s is often sufficient.<ref name="pmid23641372">{{cite journal |vauthors=Rajeshwary A, Rai S, Somayaji G, Pai V |title=Bacteriology of symptomatic adenoids in children |journal=N Am J Med Sci |volume=5 |issue=2 |pages=113–8 |year=2013 |pmid=23641372 |pmc=3624711 |doi=10.4103/1947-2714.107529 |url=}}</ref> | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Disease]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Otolaryngology]] | |||
[[Category:Pediatrics]] | |||
[[Category:Pulmonology]] | |||
[[Category:Emergency medicine]] | |||
[[Category:Infectious disease]] | |||
[[Category:Surgery]] |
Latest revision as of 20:18, 29 July 2020
Adenoiditis Microchapters |
Diagnosis |
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Treatment |
Case Studies |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2]
Overview
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.
Medical Therapy
Antibiotic therapy
- There are no proven evidence of medical therapy effectiveness in recurrent or chronic adenoiditis cases.[1]
- 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.[2]
- 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.[3]
- Nowadays with the current trend of resistant bacteria, the use of prophylactic or long-term antibiotics has been decreased.[4]
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.[5]
References
- ↑ Havas T, Lowinger D (2002). "Obstructive adenoid tissue: an indication for powered-shaver adenoidectomy". Arch. Otolaryngol. Head Neck Surg. 128 (7): 789–91. PMID 12117336.
- ↑ Casey JR, Pichichero ME. Meta-analysis of cephalosporin versus penicillin treatment of group A streptococcal tonsillopharyngitis in children. Pediatrics 2004;113:866-882.
- ↑ Huang SW, Giannoni C (2001). "The risk of adenoid hypertrophy in children with allergic rhinitis". Ann. Allergy Asthma Immunol. 87 (4): 350–5. doi:10.1016/S1081-1206(10)62251-X. PMID 11686429.
- ↑ Karlıdağ T, Bulut Y, Keleş E, Alpay HC, Seyrek A, Orhan İ, Karlıdağ GE, Kaygusuz İ (2012). "Presence of herpesviruses in adenoid tissues of children with adenoid hypertrophy and chronic adenoiditis". Kulak Burun Bogaz Ihtis Derg. 22 (1): 32–7. PMID 22339566.
- ↑ Rajeshwary A, Rai S, Somayaji G, Pai V (2013). "Bacteriology of symptomatic adenoids in children". N Am J Med Sci. 5 (2): 113–8. doi:10.4103/1947-2714.107529. PMC 3624711. PMID 23641372.