Pediatria pre prax 4/2024

Acute rhinosinusitis of the pediatric patient – actual guidelines according to the European Consensus EPOS 2020

The European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS 2020) is a guideline whose goal is to provide revised, up-to-date, and clear evidence-based recommendations and integrated care pathways in acute rhinosinusitis (ARS) and chronic rhinosinusitis (CRS). According to the EPOS guideline, ARS is divided into three phenotypes: Acute viral (common cold), acute post-viral, and acute bacterial (ABRS). Its incidence in the pediatric population is high, while the economic burden of ARS is quite heavy. The large number of medical visits, the misuse of diagnostic testing, the overuse of medications, and the high indirect costs urge systematization in patient diagnosis, guidance, and treatment. ARS is, in the vast majority of cases, an inflammatory disease, which can, in a few cases, further progress to bacterial infection. The diagnosis of uncomplicated disease is clinical, without the need for radiological studies or swabs for cultivation. For cases of ABRS, antibiotic usage per os is recommended, while antibiotic nasal drops are contraindicated. Ophthalmological and/or neurological symptoms should raise suspicion for a complication’s presence. The incidence of complications is low and independent of antibiotic use.

Keywords: acute rhinosinusitis, common cold, post-viral rhinosinusitis, acute bacterial rhinosinusitis, pediatric rhinosinusitis