A Cochrane review [Abstract] 1 included 5 studies (4 RCTs, one quasi-randomised controlled trial, CCT) with a total of 468 subjects. The RCTs compared 0.5% neomycin + 0.1% chlorhexidine (Naseptin® ) antiseptic cream with no treatment, Vaseline® petroleum jelly with no treatment, 75% with 95% silver nitrate nasal cautery, and silver nitrate cautery combined with Naseptin® against Naseptin® alone, and the CCT compared Naseptin® antiseptic cream with silver nitrate cautery. Overall, results were inconclusive, with no statistically significant difference found between the compared treatments upon completion of the trials, however 75% silver nitrate was more effective than 95% silver nitrate at 2 weeks following application. The group treated with 75% silver nitrate had 88% complete resolution of epistaxis compared to 65% in the group treated with 95% silver nitrate (P = 0.01). No serious adverse effects were reported from any of the interventions, although children receiving silver nitrate cautery reported that it was a painful experience (despite the use of local anaesthetic). The pain scores were significantly less in those treated with 75% silver nitrate, the mean score being 1 compared to a mean score of 5 in those treated with 95% silver nitrate; this was statistically significant (P = 0.001).
Primary/Secondary Keywords