Updated 15 July 2014

Oral steroids don't clear up sinus infections

Oral prednisolone is no better at reducing the symptoms of a sinus infection than a placebo.


Oral prednisolone is no better at reducing the symptoms of a sinus infection than a placebo, according to a new study.

It's possible that the steroid is simply less powerful than the body's own abilities to fight infection, said Dr Richard Rosenfeld, a professor at SUNY Downstate Medical Center and the chair of otolaryngology, who was not involved in this study.

"If you just let nature take its course, the vast majority will clear up on their own," said Dr Rosenfeld.

The research team had suspected that an oral steroid might eliminate infections sooner than letting them run their course, because steroid nasal sprays have shown a small benefit in getting people to feel better a few days earlier. "With a nose spray, the nasal discharge might prevent getting the steroids in the nasal sinuses, so we thought that administering these (systemic) corticosteroids might have some beneficial effects," said Dr Roderick Venekamp, the lead author of the study and a researcher at University Medical Center Utrecht in The Netherlands.

How the research was done

Dr Venekamp and his colleagues randomly assigned 174 patients to take either 30 mg per day of prednisolone or placebo pills for one week. The participants had experienced nasal discharge or congestion and facial pain for at least five days.

For two weeks, the people in the study kept a diary of their symptoms.

As reported online in the Canadian Medical Association Journal, the symptoms of patients' lasted just as long in the steroid group as they did in the placebo group, between seven and nine days.

Also, a similar number of patients in each group felt totally free of symptoms within a week: 33% in the steroid group and 25% in the placebo group.

Similarly, 63% in the steroid group reported no facial pain or pressure after one week, as did 56% in the placebo group. Neither of the differences was statistically significant.

Based on the findings, "we feel that systemic corticosteroids are not beneficial for the large population," Dr Venekamp said. He said that perhaps some types of patients might benefit, but more research is needed to find out who they are.

(Reuters Health, August 2012)

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Sinusitis Expert

Dr Gary Kroukamp MBCHB, FCORL(SA) is an ENT Specialist, practising from rooms at Kingsbury Hospital in Claremont, Cape Town. He also has a teaching sessional appointment as an ENT Consultant at the Tygerberg Hospital. He is a member of the ENT Society of South Africa and the South African Cochlear Implantation Group. His interests in the ENT field include sinusitis and sinus surgery, nasal allergy and ENT conditions in children.

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