1. Saline nasal irrigation for acute upper respiratory tract infections in infants and children: A systematic review and meta-analysis
- Author
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Aurélie Cabaillot, Bruno Pereirad, Mathieu Roca, Bénédicte Eschalier, Rémy Boussageon, Philippe Vorilhon, Neuro-Dol (Neuro-Dol), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Unité de Biostatistiques [CHU Clermont-Ferrand], Direction de la recherche clinique et de l’innovation [CHU Clermont-Ferrand] (DRCI), CHU Clermont-Ferrand-CHU Clermont-Ferrand, AutomédiCation aCcompagnement Pluriprofessionnel PatienT (ACCePPT), Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne (UCA), Faculté de Médecine - Clermont-Auvergne (FM - UCA), Université Clermont Auvergne (UCA), Institut Pascal (IP), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne (UCA)-Institut national polytechnique Clermont Auvergne (INP Clermont Auvergne), Université Clermont Auvergne (UCA)-Université Clermont Auvergne (UCA), Université de Poitiers - Faculté de Médecine et de Pharmacie, Université de Poitiers, and CCSD, Accord Elsevier
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,[SDV]Life Sciences [q-bio] ,Review ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,Saline nasal irrigation ,law ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Medical prescription ,Sinusitis ,Child ,Respiratory Tract Infections ,Rhinitis ,Respiratory tract infections ,business.industry ,Incidence (epidemiology) ,Upper respiratory tract infection ,Infant ,Pharyngitis ,medicine.disease ,Confidence interval ,3. Good health ,[SDV] Life Sciences [q-bio] ,Meta-analysis ,030228 respiratory system ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Nasal Lavage ,Saline Solution ,business - Abstract
International audience; Purpose: Acute upper respiratory tract infections are the most common infections in infants and children. Saline nasal irrigation (SNI) is widely prescribed and recommended. We conducted a systematic review to assess the efficacy and safety of SNI in infants and children with acute rhinopharyngitis.Methods: We searched CENTRAL, Medline, Embase and clinicalTrials.gov. Two authors selected randomized control trials (RCTs), including infants ≥3 months and children ≤12 years, comparing the use of isotonic saline solutions, whatever their mode of administration, with one therapeutic abstention, or a therapy deemed less important for nasal lavage. Trial quality was assessed independently by two authors, who, with a third author, extracted and analysed data. Statistical analysis was conducted using Comprehensive Meta-Analysis software. The standard difference in means (SMD) between groups and its 95% confidence interval were estimated.Results: Four RCTs (569 participants) were included. The analysis showed a benefit of SNI for certain clinical rhinological symptoms (SMD = -0.29 [-0.45; -0.13]) but no significant improvement of respiratory symptoms (SMD = -0.19 [-0.70; 1.08]) or health status (SMD = -0.30 [-0.68; 0.07]). Its use appeared to limit the prescription of other treatments, whether local or systemic, and particularly antibiotics. Long-term use led to a decrease in the incidence of acute rhinosinusitis and its complications. SNI appeared to be a safe treatment.Conclusions: SNI is beneficial for rhinological symptoms but not respiratory symptoms. Further research is needed to address the full benefits/risks of this treatment.
- Published
- 2019
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