Decongestants, antihistamines and nasal irrigation for acute sinusitis in children

Review question

The goal of this review was to determine whether there is any evidence in the medical literature for or against the use of decongestants, antihistamines and nasal irrigation for acute sinusitis in children.


Young children experience an average of six to eight colds per year. Out of every 10 children with a cold, one develops sinusitis. Sinusitis occurs when the sinuses, which do not drain properly during a cold, become secondarily infected with bacteria. Instead of getting better, children with sinusitis often have worsening or persistent cold symptoms. In order to alleviate the symptoms of sinusitis, parents and physicians often resort to using decongestants, antihistamines and nasal irrigation. These treatments are available without requiring a prescription and are widely used.

Previous studies have shown that the use of antihistamines and decongestants in children is associated with significant side effects.

Search date

The evidence is current to June 2014

Study characteristics

After a comprehensive review of the literature, we failed to identify any trials that evaluated the efficacy of these interventions (compared to no medication or placebo) in children with clinically diagnosed acute sinusitis.

Study funding sources

Not applicable.

Key results

No data are available to determine whether or not antihistamines or decongestants should be used in children with acute sinusitis.

Use of statistics

Not applicable.

Quality of evidence

Not applicable.

Authors' conclusions: 

There is no evidence to determine whether the use of antihistamines, decongestants or nasal irrigation is efficacious in children with acute sinusitis. Further research is needed to determine whether these interventions are beneficial in the treatment of children with acute sinusitis.

Read the full abstract...

The efficacy of decongestants, antihistamines and nasal irrigation in children with clinically diagnosed acute sinusitis has not been systematically evaluated.


To determine the efficacy of decongestants, antihistamines or nasal irrigation in improving symptoms of acute sinusitis in children.

Search strategy: 

We searched CENTRAL (2014, Issue 5), MEDLINE (1950 to June week 1, 2014) and EMBASE (1950 to June 2014).

Selection criteria: 

We included randomized controlled trials (RCTs) and quasi-RCTs, which evaluated children younger than 18 years of age with acute sinusitis, defined as 10 to 30 days of rhinorrhea, congestion or daytime cough. We excluded trials of children with chronic sinusitis and allergic rhinitis.

Data collection and analysis: 

Two review authors independently assessed each study for inclusion.

Main results: 

Of the 662 studies identified through the electronic searches and handsearching, none met all the inclusion criteria.