From the Guidelines
The treatment for a 18-month-old child with rhinorrhea and sneezing for one week is primarily supportive care, as antibiotics are not recommended for acute post-viral rhinosinusitis in children.
Key Points
- The European position paper on rhinosinusitis and nasal polyps 2020 1 provides evidence that antibiotics are not effective in treating acute post-viral rhinosinusitis in children.
- Studies such as Khoshdel 2014, Kristo 2005, and Garbutt 2001, as cited in the European position paper 1, show no significant difference in outcomes between antibiotic treatment and placebo in children with acute post-viral rhinosinusitis.
- The use of antibiotics like amoxicillin or cefuroxime axetil does not improve symptoms or cure rates in children with acute post-viral rhinosinusitis, as seen in the studies by Khoshdel 2014 and Kristo 2005 1.
- Supportive care, including saline nasal irrigation and symptomatic relief, is the recommended treatment approach for acute post-viral rhinosinusitis in children.
- It is essential to note that the child's age and symptoms should be taken into consideration, and if the symptoms worsen or persist, further evaluation and treatment may be necessary.
From the Research
Treatment Options for Rhinorrhea and Sneezing in an 18-month-old Child
- The treatment for an 18-month-old child with rhinorrhea and sneezing for one week may involve managing symptoms of allergic or nonallergic rhinitis, as the exact cause is not specified 2.
- For allergic rhinitis, treatment options include:
- Avoiding triggering allergens
- Pharmacological treatments such as intranasal/oral antihistamines or/and nasal corticosteroids 3
- Antihistamines are particularly indicated for symptoms consequent to mediators' release, mainly concerning histamine, such as itching, sneezing, and rhinorrhea 3
- Nasal corticosteroids are effective in reducing nasal obstruction, which is associated with inflammation 3
- For nonallergic rhinitis, treatment options include:
- Patient education
- Irritant or allergen avoidance
- Pharmacotherapy with medications such as intranasal corticosteroids, oral and intranasal antihistamines, intranasal anticholinergic agents, oral decongestants, and leukotriene receptor antagonists 2
- In cases where the symptoms are severe or persistent, it is recommended to consult a healthcare professional for proper diagnosis and treatment, as antibiotics may be necessary if a bacterial infection is present 4
Considerations for Treatment
- The choice of treatment depends on the severity and duration of symptoms, as well as the presence of any underlying conditions 5
- Combination therapy, such as an intranasal antihistamine spray and nasal steroid, may provide greater symptomatic relief than monotherapy 2, 5
- Allergen immunotherapy is the only disease-modifying intervention available for allergic rhinitis, but its use is typically recommended for older children and adults 3, 2, 5