Topical intranasal corticosteroid therapy in rhinitis

ALTABAX was evaluated in a placebo-controlled trial that enrolled adult and pediatric subjects aged 9 months and older for treatment of impetigo up to 100 cm² in total area (up to 10 lesions) or a total body surface area not exceeding 2%. The majority of subjects enrolled (164/210, 78%) were under the age of 13. The trial was a double-blind, randomized, multi-center, parallel-group comparison of the safety of ALTABAX and placebo ointment, both applied twice daily for 5 days. Subjects were randomized to ALTABAX or placebo (2:1). Subjects with underlying skin disease (., pre-existing eczematous dermatitis ) or skin trauma , with clinical evidence of secondary infection, were excluded from these trials. In addition, subjects with any systemic signs and symptoms of infection (such as fever) were excluded from the trial. Clinical success was defined as the absence of treated lesions, or treated lesions had become dry without crusts with or without erythema compared with baseline, or had improved (defined as a decline in the size of the affected area, number of lesions or both) such that no further antimicrobial therapy was required. The intent-to-treat clinical (ITTC) population consisted of all randomized subjects who took at least 1 dose of trial medication. The clinical per protocol (PPC) population included all ITTC subjects who satisfied the inclusion/exclusion criteria and subsequently adhered to the protocol. The intent-to-treat bacteriological (ITTB) population consisted of all randomized subjects who took at least 1 dose of trial medication and had a pathogen identified at trial entry. The bacteriological per protocol (PPB) population included all ITTB subjects who satisfied the inclusion/exclusion criteria and subsequently adhered to the protocol.

The studies cited above used a variety of methods for extemporaneous compounding of TXA ranging from % to 10% solutions. Two methods have been suggested depending on the formulation used. ( 21275495 ) If the 100 mg/mL or 10% solution for injection is used, a 5% oral solution can be prepared by diluting 5 mL of tranexamic acid with 5 mL of sterile water. If the 500 mg tablets are available, one tablet can be placed into 20 mL of water, and stirred until the tablets are completely disintegrated to form a fine particular suspension. It is suggested that a maximum expiration date of five days should be employed if refrigerated, and the solution should be protected from light. 3  In the place of a 500 mg tablet, it seems that use of a 650 mg tablet dissolved in 20 mL could be safely used as well. This is supported by evidence in which a 500 mg tablet was dissolved in 10 mL of water with no reports of adverse events. ( 24808695 ) There is evidence to support that an even lower concentration may be effective, as a % solution was utilized by Kaewpradub and colleagues, although higher concentrations have safely been used.

There were 91 pediatric subjects aged 2 months to 15 years in the first trial described above. Clinical efficacy rates at end of therapy in the evaluable populations were 78% for BACTROBAN ointment (n = 42) and 36% for vehicle placebo (n = 49). In the second trial described above, all subjects were pediatric except 2 adults in the group receiving BACTROBAN ointment. The age range of the pediatric subjects was 7 months to 13 years. The clinical efficacy rate for BACTROBAN ointment (n = 27) was 96%, and for erythromycin it was unchanged (%).

One measure used in the management of staphylococcal disease outbreaks in newborn nurseries is to obtain nasal cultures from nursery personnel and then treat nasal carriers with topical antibiotic ointments. Because recent infection control guide-surveyed current practices in larger hospitals in the . Seventy-one percent of respondents indicated that they would obtain nasal cultures from personnel during a staphylococcal disease outbreak, and 40% indicated that they would prescribe topical antibiotic ointments for personnel with positive nasal cultures before the results of bacteriophage typing became known. Because little has been written about the efficacy of topical intranasal antibiotics within the past decade, we compared bacitracin ointment with a vancomycin ointment for treatment of the staphylococcal nasal carrier state. Both ointments reduced nasal carriage in the majority of instances. However, similar reduction was also observed in an untreated control group. The need for different approaches to the problem of nasal carriers is discussed.

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  • Citation tools Download this article to citation manager Williamson Ian , Benge Sarah , Barton Sheila , Petrou Stavros , Letley Louise , Fasey Nicky et al. Topical intranasal corticosteroids in 4-11 year old children with persistent bilateral otitis media with effusion in primary care: double blind randomised placebo controlled trial BMJ 2009; 339 :b4984
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    Topical intranasal corticosteroid therapy in rhinitis

    topical intranasal corticosteroid therapy in rhinitis

    One measure used in the management of staphylococcal disease outbreaks in newborn nurseries is to obtain nasal cultures from nursery personnel and then treat nasal carriers with topical antibiotic ointments. Because recent infection control guide-surveyed current practices in larger hospitals in the . Seventy-one percent of respondents indicated that they would obtain nasal cultures from personnel during a staphylococcal disease outbreak, and 40% indicated that they would prescribe topical antibiotic ointments for personnel with positive nasal cultures before the results of bacteriophage typing became known. Because little has been written about the efficacy of topical intranasal antibiotics within the past decade, we compared bacitracin ointment with a vancomycin ointment for treatment of the staphylococcal nasal carrier state. Both ointments reduced nasal carriage in the majority of instances. However, similar reduction was also observed in an untreated control group. The need for different approaches to the problem of nasal carriers is discussed.

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