Adenoiditis medical therapy
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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.