A Systematic Review of Phytotherapy for Acute Rhinosinusitis

Koch, Anna K.; Klose, Petra; Lauche, Romy; Cramer, Holger; Baasch, J.; Dobos, Gustav; Langhorst, Jost

doi:10.1159/000447467

Cited by 26 publications

(15 citation statements)

References 8 publications

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“…In consequence, the EPOS guidelines recommended their use in adult ARS. 1 A recent meta-analysis by Kock et al 24 has confirmed the efficacy of some herbal compounds such as EPs 7630, Myrtol, BNO 101, BNO 1016, CE and Esberitox. In the present study, an association was found between the use of CE and a shorter disease duration, suggesting CE be accepted by physicians as a treatment choice for ARS.…”

Section: Discussionmentioning

confidence: 98%

Overuse of diagnostic tools and medications in acute rhinosinusitis in Spain: a population-based study (the PROSINUS study)

et al. 2018

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ObjectivesAcute rhinosinusitis (ARS) has a high incidence. Diagnosis is clinical, and evolution is mostly self-limited. The aim of this study was to describe the sociodemographic characteristics and use of diagnostic tools and medications in patients with ARS.DesignThis is a prospective observational study in real-life clinical practice.SettingPatients with clinical diagnosis of ARS (n=2610) were included from ear, nose and throat clinics in Spain. A second visit at resolution was done.ParticipantsPatients were classified according to the duration of symptoms: viral ARS (≤10 days), postviral ARS (>10 days, ≤12 weeks) and chronic rhinosinusitis (>12 weeks).Main outcome measuresSociodemographic characteristics, symptoms, disease severity, quality of life (Sino-Nasal Outcome Test-16), used diagnostic tools and medications, and the management performed by primary care physicians (PCPs) and by otorhinolaryngologists (ORLs) were assessed.ResultsOf the patients 36% were classified as having viral ARS, 63% postviral ARS and 1% as chronic rhinosinusitis. Working in a poorly air-conditioned environment was a risk factor (OR: 2.26, 95% CI 1.27 to 4.04) in developing postviral ARS. A higher number of diagnostic tools (rhinoscopy/endoscopy: 80% vs 70%; plain X-ray: 70% vs 55%; CT scan: 22% vs 12%; P<0.0001) were performed in postviral than viral cases. PCPs performed more X-rays than ORLs (P<0.0001). Patients, more those with postviral than viral ARS, received a high number of medications (oral antibiotics: 76% vs 62%; intranasal corticosteroids: 54% vs 38%; antihistamines: 46% vs 31%; mucolytic: 48% vs 60%; P<0.0001). PCPs prescribed more antibiotics, antihistamines and mucolytics than ORLs (P<0.0068). More patients with postviral than viral ARS reported symptoms of potential complications (1.5% vs 0.4%; P=0.0603). Independently of prescribed medications, quality of life was more affected in patients with postviral (38.7±14.2 vs 36.0±15.3; P=0.0031) than those with viral ARS. ARS resolution was obtained after 6.04 (viral) and 16.55 (postviral) days, with intranasal corticosteroids being associated with longer (OR: 1.07, 95% 1.02 to 1.12) and phytotherapy with shorter (OR: 0.95, 95% CI 0.91 to 1.00) duration.ConclusionsThere is a significant overuse of diagnostic tools and prescribed medications, predominantly oral antibiotics, by PCPs and ORLs, for viral and postviral ARS.

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Section: Discussionmentioning

confidence: 98%

Overuse of diagnostic tools and medications in acute rhinosinusitis in Spain: a population-based study (the PROSINUS study)

et al. 2018

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“…Until the 1990s, evidence for the use of herbal products in acute rhinosinusitis remained largely anecdotal. However, in the past 20 years, randomized controlled trials in rhinosinusitis have been performed with a number of herbal products [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Evidence-based management of acute rhinosinusitis with herbal products

Bachert

2020

Clin Phytosci

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Background The overuse of antibiotics for unjustified indications such as the management of acute uncomplicated rhinosinusitis has contributed to the emergence of antibiotic-resistant strains of bacteria and prompted the need for alternative treatments. This review assesses the quality of evidence for the management of acute rhinosinusitis with herbal products, with the goal of positioning them among other treatments and identifying future research directions. The MEDLINE database was searched for randomized controlled trials with Sinupret®, Pelargonium sidoides extract, Cyclamen europaeum (CE), cineole, and GeloMyrtol®. Searches with N-acetylcysteine and mometasone furoate nasal spray (MFNS) were performed to compare the strength of evidence of herbal products to these conventional products, which are indicated for acute rhinosinusitis. Main body Evidence was strongest for Sinupret, followed by Pelargonium sidoides extract. Their use in acute rhinosinusitis is supported by randomized placebo-controlled trials demonstrating both clinical efficacy and safety. Comparative data with conventional treatments such as topical glucocorticosteroids were found only for Sinupret and suggested comparable efficacy in a small study. For other herbal products, the overall level of evidence was low. The search retrieved two small-scale placebo-controlled randomized studies with CE nasal spray. The two trials were not powered to draw conclusions about the safety and efficacy of CE nasal spray and reported a lack of efficacy with CE on symptom reduction. Only one randomized placebo-controlled trial was identified for GeloMyrtol and cineole. These suggested an improvement in acute rhinosinusitis symptoms with both products, but the results warrant replication in larger trials. Studies directly comparing herbal products are scarce; one randomized trial has compared cineole with Sinupret, but the results need confirmation in further studies. Studies with N-acetylcysteine are limited to small-scale clinical trials, while MFNS is supported by a strength of evidence comparable to Sinupret in this indication. Conclusion State-of-the-art studies demonstrating the efficacy and safety of herbal products for the management of acute rhinosinusitis are available. Given that the evidence for Sinupret is the strongest and comparable to that of a widely available topical corticosteroid, MFNS, Sinupret may be considered for the management of acute uncomplicated rhinosinusitis.

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“…According to the epidemiological data as well as expert opinions of the prominent world clinicians and scientists, ARS remains to be the leading disease in the outpatient practice, which significantly decreases the quality of life as well as makes a great socio-economic impact in society (3)(4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

Histomorphological Study of a New Nasal Spray with Anti-inflammatory Properties Efficacy in Rabbits with Rhinosinusitis

et al. 2020

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Introduction: The high world prevalence of rhinosinusitis (RS) initiates the ways of a favorable search for effective and safe medicines for its pathogenetic treatment. The important part of this process is the choice of the most comfortable dosage form, which will enhance therapeutic compliance and ensure the appropriate medicine efficacy and safety. Aim: To substantiate the efficacy of a new nasal spray with anti-inflammatory properties containing Enisamium Iodide (EI) at a concentration of 10 mg/mL by histomorphological study of the nasal cavity and paranasal sinuses mucosal in rabbits with experimental rhinosinusitis (ERS). Methods: EI (nasal spray) was a test object. Sinupret ® was a reference drug. ERS was induced in rabbits on the first day of the study by tamponade of the right half of the nasal cavity under general anesthesia. The study was performed using 24 rabbits (4 groups, 6 rabbits in each group). The histomorphological examination was performed on the 25 th day of the study by the standard light microscopy methods. Results: The histomorphological examination of EI 10 mg/mL (nasal spray) impact on RS in rabbits, which administered during 10 days intranasally, revealed the significant therapeutic effect presented by reduced inflammation signs in the epithelium of the nasal cavities and paranasal sinuses mucosal. Besides, the EI impact was not inferior to the reference drug Sinupret ® in tablets. The study of the pharmacological properties of the EI (nasal spray) on ERS showed the high rate of onset of EI actions when used intranasally which was superior to the rate of actions of the reference drug Sinupret ® (tablets) administered intragastrically. Conclusion: The EI (nasal spray) is a promising drug for a pathogenetic therapy of acute RS, which demands further pre-clinical and clinical studies aiming to substantiate its implementation to the clinical practice.

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A Systematic Review of Phytotherapy for Acute Rhinosinusitis

Cited by 26 publications

References 8 publications

Overuse of diagnostic tools and medications in acute rhinosinusitis in Spain: a population-based study (the PROSINUS study)

Overuse of diagnostic tools and medications in acute rhinosinusitis in Spain: a population-based study (the PROSINUS study)

Evidence-based management of acute rhinosinusitis with herbal products

Histomorphological Study of a New Nasal Spray with Anti-inflammatory Properties Efficacy in Rabbits with Rhinosinusitis

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