6
Treatment
Table 3. Grade A/B Evidence-based Recommendations for
Medical Management of ARS
Intervention Grade Benefit Harm
ARS:
Antibiotic Treatment
B Shorter symptom
duration, reduced
pathogen carriage
GI complaints,
resistance, anaphylaxis.
See Table 9
Pediatric ARS
<10 days:
Withholding
Antibiotic Treatment
A Avoidance of unnecessary
medications
Potential progression of
disease
ARS: Intranasal
Corticosteroids
A Improved symptoms as
monotherapy in mild to
moderate cases and as
adjuvant to antibiotics in
severe cases. May shorten
recovery
Minimal harm with rare
adverse events.
See Table 9
ARS: Topical Saline
Spray and Irrigation
B No benefit to 10 cc syringe
but possible improvement
in patency, rhinorrhea,
and post-nasal drip with
high volume irrigation
Unclear but possible ear
fullness, or irritation.
See Table 9
