This study included 120 patients who presented with symptoms of rhinosinusitis. All patients were diagnosed clinically and treated either with amoxicillin alone or with a combination of mometasone furoate nasal spray and amoxicillin.
This study demonstrated that MFNS administered twice a day along with antibiotics would help patients to get relief of symptoms in patients with ARS and help them to return to their day-to-day activity as earliest as possible.
In the study conducted by Meltzer et al., patients were treated for 21 days with amoxicillin clavulanate potassium and randomized to receive concurrent mometasone furoate nasal spray (MFNS) 400 μg, twice daily in 200 patients or placebo spray, and twice daily in 207 patients. Patient-recorded twice-daily symptom scores showed that adjunctive treatment with MFNS caused a significantly greater decrease in total symptom scores and in individual scores of inflammatory symptoms associated with the obstruction process (headache, congestion, and facial pain) compared with placebo [17].
Nayak et al. conducted a study, in which 967 outpatients with computed tomographic scan-confirmed moderate to severe rhinosinusitis received amoxicillin clavulanate 875 mg, twice daily, for 21 days with adjunctive twice-daily MFNS 200 μg, MFNS 400 μg, or placebo nasal spray. As adjunctive therapy to oral antibiotic treatment, MFNS at doses of 200 μg or 400 μg, twice daily, was well tolerated and significantly more effective in reducing the symptoms of rhinosinusitis than antibiotic therapy alone [9].
In our study, the age ranged from 13 to 64 years with the mean age being 28.6 years. In a study done by Nayak et al. [9], the mean age of patients was 39 years, and the age ranged from 8 to 78 years. In another study done by Meltzer et al. [17] in 2000, the mean age of patients was 40.3 years, and the age ranged from 12 to 73 years. In a similar study conducted by Meltzer et al. [18] in 2005, the mean age of patients was 35 years. The majority of patients in our study were in the age group of 18–35 years, i.e., 67 (55.8%) followed by patients in the age group of 36–55 years, i.e., 22 (19.3%) patients. Similar to our study in all the abovementioned studies, the mean age of the patients was in the adult group; we can say that ARS is more common in adults.
In our study, among 120 patients, most of them were females, i.e., 67.5% (81), and 32.5% were males (39) with male to female ratio being 1:2. The study conducted by Meltzer et al. in 2000 had 64% females (260) and 36% males (147) with male to female ratio being 1:1.7 [17]. In the study conducted by Nayak et al., there were 58.4% females (564) and 41.6% males (403) with male to female ratio being 1:1.4 [9]. Similar to this study, all the abovementioned studies had a higher incidence of ARS among females. Also, in all the abovementioned studies, most of the patients were in the reproductive age group. Females tend to have more close contact with young children who are more prone to upper respiratory tract infections. Therefore, females in their reproductive age group were more prone to acquire ARS.
In our study, there was a significant improvement in symptoms of blockage of the nose, thick nasal discharge, and facial pain in both groups. Similar to the abovementioned study, there was a decrease in the mean score of blockage of the nose, thick nasal discharge, and facial pain in both groups. However, there was a greater improvement in the symptom in patients using amoxicillin with MFNS (Fig. 3).
In our study, there was a significant improvement in cough and postnasal discharge in both groups. However, the study conducted by Nayak et al. [9] and Meltzer et al.27 in 2000 did not show a significant improvement in symptoms in amoxicillin with the MFNS group compared to the amoxicillin group.
Our study was able to see the effect of ARS on a patient’s life causing a troublesome impact on daily activities. Symptoms like difficulty falling asleep, waking up at night, lack of a good night’s sleep, waking up tired, fatigue during the day, reduced productivity, reduced concentration, frustration, sad, and embarrassed were assessed. All the patients receiving MFNS had significant improvement in these symptoms.
Our study showed significant improvement in overall SNOT-22 symptoms score in patients receiving MFNS with amoxicillin. It was similar to the studies conducted by Nayak et al. and Meltzer et al. in 2000 that showed an addition of intranasal corticosteroid; MFNS to antibiotics significantly reduces symptoms of acute rhinosinusitis compared with amoxicillin alone [9, 17].