A Cochrane review [Abstract] 1 included 3 studies with a total of 353 subjects. They suffered from naturally developed colds. Two trials compared intranasal corticosteroids to placebo and one trial compared intranasal corticosteroids to usual care. Neither trial reported the primary outcome measure of percentage of participants with resolution at different time points. A lack of comparable outcome measures prevented combining the data. No benefit of intranasal corticosteroids was demonstrated for duration or severity of symptoms. In one trial (n=54) the number of symptomatic days was 10.3 in the placebo group, compared to 10.7 in those using intranasal corticosteroids (p = 0.72). A second trial (n=199) reported no significant differences in duration of symptoms. There were no differences reported in terms of: adverse events; complications (one case of sinusitis, one case of acute otitis media, both in corticosteroid groups); presence of rhinovirus in nasal aspirates; or treatment for secondary infections. The third, single-blind trial in children aged 2 to 14 years (n=100), who were also receiving oral antibiotics, had inadequate reporting of outcome measures regarding symptom resolution. Mean symptom severity scores were significantly lower in the group receiving intranasal steroids in addition to oral amoxicillin.
Comment: The quality of the evidence is downgraded by imprecise results (few studies) and indirectness (differences in reported outcomes, there are no data on patients older than 57 years).
Date of latest search:
Primary/Secondary Keywords