Intranasal betamethasone valerate in the treatment of seasonal rhinitis

Otitis media with effusion: results of treatment with a short course of oral prednisone or intranasal beclomethasone aerosol

A short course of prednisone suspension given in a decreasing dosage schedule for up to ten days was often effective (68%) in resolving mucoid otitis media with effusion (OME, middle ear effusion). No significant side effects were noted. Concommitant administration of sulfisoxazole suspension may have reduced the likelihood of activation of a quiescent infection of the middle ear. During the eight-month mean follow-up period, reaccumulation of the effusion was detected in 21% of the successfully treated children. Preliminary results of an unrelated, pilot project using intranasal beclomethasone dipropionate aerosol suggests that this novel method also may be efficacious in the treatment of OME.

Allergic rhinitis: diagnosis and management

Allergic rhinitis affects up to 20 per cent of the pediatric population and occurs in children of all ages. Secondary infection, dental malocclusion and a variety of other sequelae may complicate the primary disorder. The diagnosis of allergic rhinitis is based on historic features, physical findings and selected laboratory investigations. Treatment may involve antigen avoidance programs and immunotherapy. However, pharmacotherapy with antihistamines, sympathomimetics and, in severe cases, corticosteroids, is most frequently used.

Betamethasone valerate aerosol in the treatment of oral lichen planus

Betamethasone valerate aerosol, given in doses of up to 800 microgram per day, was compared with placebo in a double-blind trial involving 23 patients with oral lichen planus. The majority of patients receiving the active aerosol noted improvement within the first 2 weeks of treatment and at 8 weeks the lesions had almost cleared; in contrast, only 2 patients on placebo showed slight improvement over the same time period. The results suggest that this form of treatment is an effective and acceptable method of controlling the discomfort due to oral lichen planus, especially where minor erosions are present.

Beclomethasone dipropionate aerosol in perennial rhinitis

Beclomethasone dipropionate aerosol (BDA), 50 mug four times daily sprayed into each nostril, was compared with placebo in a double-blind crossover trial in 26 patients with perennial rhinitis. Patients received BDA for 3 weeks and placebo for 3 weeks; the order of administration was randomized. Response was assessed with daily symptom score cards and twice weekly measurements of nasal airway inspiratory resistance at a standard flow rate of 0.4 L/sec. Symptom score and nasal resistance during BDA treatment were significantly lower than those duirng placebo treatment (p less than 0.02 and p less than 0.05, respectively) in the third week. Eighteen of the patients expressed a preference for BDA, 6 for placebo, and 2 for neither (p less than 0.05). Acceptable symptomatic improvement (moderate or marked) was achieved by 54%. Mild side effects were noted by 5 patients; these included nasal irritation and bleeding in 2, aerosol-induced sneezing in 2, and headache in 1. These side effects occurred in 3 patients who used BDA, 1 who used placebo, and 1 who used both. After a 6-mo follow-up period, in which the dose of BDA was adjusted and concurrent initial oral prednisone was administered to patients who were treatment failures, 73% of the patients obtained moderate or marked symptomatic improvement. No further side effects were noted during this time. Results in those in whom a possible allergic component could be identified were not different from those of the whole group. We conclude that BDA is a useful addition to the therapy of perennial rhinitis.

Intranasal steroid aerosol in perennial rhinitis: comparison with an antihistamine compound

Intranasal betamethasone valerate aerosol, given for 28 days, was compared with an oral antihistamine compound in a couble-blind, double-dummy, cross-over trial involving thirty patients with perennial rhinitis. The steroid aerosol was more effective in reducing symptoms and was preferred by the patients (P less than 0-01). Nasal blockage index, calculated from oral and nasal peak expiratory flow measurements, did not provide useful or additional information. There were no side effects from the steroid and Candida albicans was not cultured from nasal swabs. It is concluded that beta-methasone valerate aerosol is a suitable short-term alternative for patients whose perennial rhinitis fails to respond to conventional therapy.