Saavedra MAGM, Akaki CM

Language: Spanish
References: 18
Page: 188-193
PDF size: 280.86 Kb.

ABSTRACT

Evidence-based medicine (EBM) is the integration of the best scientific research evidence with clinical experience and patients’ profile, classified according to the information’s evidence level and degree of recommendation to obtain the best guide in the diagnosis and treatment decision making process. It is necessary a reassessment and an update based upon the best scientific evidence of a such frequent pathological entity as pediatric rhinosinusitis, when inconsistent existing data regarding diagnostic approaches and important changes in the clinical course facing an era of more antibiotic resistance, are more often observed. The upper respiratory tract viral infection is the most frequent cause in bacterial rhinosinusitis. The clinical course, mainly, the persistence and severity of symptoms help distinguish among these two. The diagnosis is based on clinical criteria and imaging studies are not recommended as a diagnostic tool in a noncomplicated acute episode.

REFERENCES

1. Evidence-Based Medicine Working Group. Evidence-Based Medicine. A new approach to teaching the practice of medicine. JAMA 1992;268:2420-2425.

2. Miller J. Scottish Intercollegiate Guidelines Network Grading Review Group. A new system for grading recommendations in evidence based guidelines. BMJ 2001;323:334-336.

3. Instructivo para autores. Niveles de evidencia para la pregunta de investigación. Traducido del inglés por Armando Torres-Gómez con autorización de The Journal of Bone and Joint Surgery. Adaptado y utilizado con permiso del Oxford Centre for Evidence Based Medicine. Rev Mex Ortop Ped 2009;11(1):48-50.

4. Oxford Centre for Evidence-based Medicine. Levels of Evidence en http://www.cebm.net. Phillips B, Ball C, Sackett D, Badenoch D, Straus S, Haynes B, Dawes M. Nov 1998 Howick J. Mar 2009 (actualización).

5. American Academy of Pediatrics. Clinical practice guideline: Management of sinusitis. Pediatrics 2001;108:798-808.

6. Nagayama Y, Tsubaki T, Nakayama S. Bacterial colonization in respiratory secretions from acute and recurrent wheezing infants and children. Pediatr Allergy Immunol 2007;18:110-117.

7. Leo G, Mori F, Icorvaia C. Diagnosis and management of acute rhinosinusitis in children. Curr Allergy Asthma Rep 2009;9:232-237.

8. Esposito S, Principi N. Guidelines for the diagnosis and treatment of acute and subacute rhinosinusitis in children. J Chemother 2008;20(2):147-157.

9. Steele R. Rhinosinusitis en children. Curr Allergy Asthma Rep 2006;6:508-512.

10. Esposito S, Bosis S, Bellasio M. From clinical practice to guidelines: how to recognize rhinosinusitis in children. Pediatr Allergy Immunol 2007;18(Suppl. 18):53-55.

11. Acute Bacterial Sinusitis Guideline Team, Cincinnati Children’s Hospital Medical Center: Evidence-based care guideline for medical management of acute bacterial sinusitis in children 1 through 17 years of age. http://www.cincinnatichildrens.org/svc/alpha/h/health-policy/ev-based/sinus.htm. Guideline 16, pg 1-17, Jul. 7, 2006.

12. Slavin RG, Spector SL, Bernstein IL. Joint Task Force on Practice Parameters. The diagnosis and management of sinusitis: a practice parameter update. J Allergy Clin Immunol 2005;116(Suppl. 6):S13-S47.

13. Costa Carvalho BT, Nagao AT, Arslanian C. Immunological evaluation of allergic respiratory children with recurrent sinusitis. Pediatr Allergy Immunol 2005;11:534-538.

14. Brook I. Bacteriology of acute and chronic ethmoid sinusitis. J Clin Microbiol 2005;43:3479-3480.

15. Nash D, Wald E. Sinusitis. Pediatr Rev 2001;22:111-116.

16. Wald ER. Beginning antibiotics for acute rhinosinusitis and choosing the right treatment. Clin Rev Allergy Immunol 2006;30:143-152.

17. Meltzer EO, Hamilos DL, Hadley JA. Rhinosinusitis: establishing definitions for clinical research and patient care. J Allergy Clin Immunol 2004;114:155.

18. Blomgren K, Alho OP, Ertama L. Acute sinusitis: Finnish clinical practice guidelines. Scand J Infect Dis 2005;37:245-250.