Cefuroxime axetil versus placebo for children with acute respiratory infection and imaging evidence of sinusitis: A randomized, controlled trial

Aim: To evaluate the efficacy of antibiotic treatment in children who presented in medical care with respiratory infection and had imaging evidence of sinusitis. Methods: Eighty‐two children (4–10 y) with acute respiratory symptoms and ultrasonography findings suggestive of acute rhinosinusitis were enrolled in a randomized, double‐blind trial. The sinus findings were confirmed with plain radiographs. The children received either cefuroxime axetil in 125‐mg capsules twice a day for 10 d or placebo. Main outcome measures were complete cure in 2 wk and absence of prolonged symptoms or complications. Results: A total of 72 children (88%) completed follow‐up. The sinusitis findings in the ultrasound could be confirmed with plain radiographs in 65 of the 72 patients (90%). The proportion of children completely cured by day 14 was similar in both groups (difference 6%, 95% confidence interval −16% to 29%). Similarly, there was no significant difference in the proportions of children who escaped prolonged disease and complications between the groups (difference 7%, −9% to 24%). Conclusion: A 10‐d course of cefuroxime axetil offered no clinical benefit to children with an acute respiratory illness and imaging evidence of acute sinusitis.