***TASK*** the task is to summarize an input biomedical literature in six sentences 
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    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: In the present study 141 children aged between 3 and 10 years and suffering from chronic maxillary sinusitis were treated non-selectively in one of 4 ways : amoxicillin combined with decongestive nose drops , drainage of the maxillary sinus , a combination of the two , or a placebo . The duration of the follow-up period was 6 months . The therapeutic effects of the 4 forms of treatment did not differ significantly . Haemophilus influenzae and streptococcus pneumoniae were the micro-organisms encountered most often in these children . The results are discussed OBJECTIVE To compare the efficacy of amoxicillin vs placebo in patients with an acute upper respiratory tract infection and purulent rhinorrhea . STUDY DESIGN Double-blind r and omized placebo-controlled trial . POPULATION The 416 patients included from 69 family practice s were 12 years or older , presenting with acute upper respiratory complaints , and having a history of purulent rhinorrhea and no signs of complications of sinusitis . OUTCOMES MEASURED Therapy success ( disappearance of symptoms that most greatly affected the patient 's health ) at day 10 and duration of general illness , pain , and purulent rhinorrhea . RESULTS Therapy was successful in 35 % of patients with amoxicillin and in 29 % of patients with placebo ( relative risk [ RR ] 1.14 , 95 % confidence interval [ CI ] , 0.92 - 1.42 ) . There was no effect on duration of general illness or pain . Duration of purulent rhinorrhea was shortened by amoxicillin ( 9 days vs 14 for clearing of purulent rhinorrhea in 75 % of patients ; P = .007 ) . Diarrhea was more frequent with amoxicillin ( 29 % vs 19 % , RR 1.28 , 95 % CI , 1.05 - 1.57 ) . No complications were reported . One patient ( 0.5 % ) receiving amoxicillin and 7 ( 3.4 % ) receiving placebo discontinued trial therapy because of exacerbation of symptoms ( RR 0.25 , 95 % CI 0.04 - 1.56 , P = .07 ) . All 8 patients recovered with antibiotic therapy . CONCLUSIONS Amoxicillin has a beneficial effect on purulent rhinorrhea caused by an acute infection of the nose or sinuses but not on general recovery . The practical implication is that all such patients , whatever the suspected diagnosis , can be safely treated with symptomatic therapy and instructed to return if symptoms worsen BACKGROUND In response to the dramatic emergence of resistant pneumococci , more judicious use of antibiotics has been advocated . Physician beliefs , their prescribing practice s , and the attitudes of patients have been evaluated previously in separate studies . METHODS This 3-part study included a statewide mailed survey , office chart review s , and parent telephone interviews . We compared survey responses of 366 licensed pediatricians and family physicians in Georgia to recently published recommendations on diagnosis and treatment of upper respiratory infections ( URIs ) . We further evaluated 25 r and omly selected pediatricians from 119 surveyed in the Atlanta metropolitan area . For each , charts from the first 30 patients between the ages of 12 and 72 months seen on a r and omly selected date were review ed for encounters during the preceding year . A sample of parents from each practice were interviewed by telephone . RESULTS In the survey , physicians agreed that overuse of antibiotics is a major factor contributing to the development of antibiotic resistance ( 97 % ) , and that they should consider selective pressure for resistance in their decisions on providing antibiotic treatment for URIs in children in their practice s ( 83 % ) . However , many reported practice s do not conform to the recently published principles for judicious antibiotic use . For example , 69 % of physicians considered purulent rhinitis a diagnostic finding for sinusitis ; 86 % prescribed antibiotics for bronchitis regardless of the duration of cough ; and 42 % prescribed antibiotics for the common cold . Reported practice s by family physicians were more often at odds with the published principles : they were significantly more likely than pediatricians to omit pneumatic otoscopy ( 46 % vs 25 % ) ; to omit the requirement for prolonged symptoms to diagnose sinusitis ( median 4 vs 10 days ) ; and to omit laboratory testing for pharyngitis ( 27 % vs 14 % ) . Of the 7531 encounters analyzed in the chart review , 43 % result ed in an antibiotic prescription , including 11 % of checkups , 18 % of telephone calls , and 72 % of visits for URIs . There was wide variability in the overall antibiotic use rates among the 25 physicians ( 1 - 10 courses per child per year ) . There was an even wider variability in some diagnosis-specific rates ; bronchitis and sinusitis in particular . Those with the highest antibiotic prescribing rates had up to 30 % more return office visits . Physicians who prescribed antibiotics for purulent rhinitis were more likely to see parents who believed that their children should be evaluated for cold symptoms . CONCLUSIONS Physicians recognize the problem of antibiotic resistance but their reported practice s are not in line with recently published recommendations for most pediatric URIs . The actual prescribing practice s of pediatricians are often considerably different from their close colleagues . Patient beliefs are correlated with their own physician 's practice This study was performed to investigate the course of spontaneous recovery from otitis media with effusion in children with chronic rhinosinusitis treated in various ways . One hundred forty-one children between 3 and 10 years of age were selected for the presence of chronic rhinosinusitis and unilateral or bilateral otitis media with effusion . The children were assigned at r and om to one of four treatment groups , i.e. , placebo , amoxicillin combined with xylometazoline hydrochloride nose drops , maxillary sinus drainage , or a combination of the latter two forms of therapy . The follow-up period was 6 months . Drainage of the maxillary sinus had no effect on either the recovery of the chronic upper respiratory tract infection or otitis media with effusion . Amoxicillin combined with xylometazoline nose drops had no significant effect on recovery from the upper respiratory tract infection , but did have a small but significant effect on recovery from otitis media with effusion . However , the general tendency of the upper respiratory tract and ears to recover was poor . Persistence of the chronic upper respiratory tract infection during the follow-up period proved to be a negative prognostic factor with respect to cure of otitis media with effusion .  Children with chronic rhinosinusitis as defined in this study appear to have a high risk of developing chronic otitis media with effusion . The results of the study are discussed A double-blind r and omized controlled trial of amoxycillin , co-trimoxazole , and placebo was conducted on 197 children presenting with presumed viral respiratory infections . Routine throat swabs were taken to exclude streptococcal diseases . The three disease categories studied -- nasopharyngitis , pharyngotonsillitis , and bronchitis ( including laryngotracheobronchitis)--showed a generally similar pattern of resolution irrespective of treatment . Nevertheless , seven out of 66 children receiving placebo were withdrawn from the trial with unremitting symptoms or complications thought to require antimicrobial treatment . Only two of 56 children receiving amoxycillin and none of 75 receiving co-trimoxazole were withdrawn . Three other children receiving amoxycillin and three receiving placebo were seen during the trial but further treatment was not thought to be necessary . Thus the return consultation rate in children receiving placebo therapy was 15 % compared with 4 % for those receiving antimicrobial treatment . Antimicrobial treatment was associated with less nasal discharge on the eighth day of treatment . Placebo treatment allowed an earlier return to normal activity . There was a high incidence of possible side effects on all regimens including placebo . It is concluded that the benefits of antimicrobial treatment in presumed viral respiratory infections are marginal , and they should not be routinely prescribed for these conditions Purulent  nasal discharge  ( discharge that is thick , opaque and colored ) is a common clinical symptom in pediatrie patients . Although it may occur at any age it is probably most problematic and most common in children between birth and 2 to 3 years of age . This article review s the differential diagnosis , evaluation and management of purulent nasal discharge in children Objective . Although antimicrobial treatment for children with acute sinusitis is used commonly , it is unclear whether it offers significant clinical benefit . The purpose of this study was to evaluate the effectiveness of antimicrobial treatments for acute sinusitis as they are used in community pediatric practice . Methods . We conducted a r and omized , placebo-controlled trial in 3 community pediatric practice s in St Louis , Missouri . A total of 188 patients who were between the ages of 1 and 18 years and who had had 10 to 28 days of persistent sinus symptoms and a clinical diagnosis of acute sinusitis were r and omized to receive 14 days of amoxicillin ( 40 mg/kg/d in 3 daily doses ) , amoxicillin-clavulanate ( amoxicillin 45 mg/kg/d in 2 daily doses ) , or placebo .  Change in sinus symptoms was assessed both by a quantitative symptom score ( the S5 score ) and subjectively by the parent . Secondary outcomes included adverse effects of treatment and recurrence or relapse of sinus symptoms . Outcomes were assessed by telephone interviews over a 2-month period . Results . Of the 161 patients who were included in the analysis , 58 received amoxicillin , 48 received amoxicillin-clavulanate , and 55 received placebo . Day 14 improvement rates were 79 % , 81 % , and 79 % , respectively . There were no differences in the 14-day change in S5 score among treatment groups . The rates of adverse events ( amoxicillin , 19 % ; amoxicillin-clavulanate , 11 % ; placebo , 10 % ) , relapse ( amoxicillin , 12 % ; amoxicillin-clavulanate , 13 % ; placebo , 13 % ) , and recurrence ( amoxicillin , 9 % ; amoxicillin-clavulanate , 13 % ; placebo , 13 % ) of sinus symptoms were similar among treatment groups . Conclusion . Neither amoxicillin nor amoxicillin-clavulanate offered any clinical benefit compared with placebo for children with clinical ly diagnosed acute sinusitis We evaluated the role of antimicrobials in the treatment of  chronic maxillary sinusitis in children with respiratory allergy . Night and day cough , nasal obstruction , rhinorrhea , postnasal seen . Eighty-four children were treated in a double-blind manner with either amoxicillin , erythromycin , trimethoprim-sulfamethoxazole , or an antihistamine decongestant ( carbinoxamine maleate-pseudoephedrine HCl ) . Radiographic and clinical responses were best with amoxicillin , but trimethoprim-sulfamethoxazole was an adequate alternative . This study demonstrates that allergic children with chronic sinusitis with associated chronic respiratory symptoms are likely to respond clinical ly and radiologically with antimicrobial treatment Sc and J Prim Health Care 2003;21:00 - 00 . ISSN 0281 - 34323 Objectives r - r To compare antibiotics and placebo in patients with clinical ly diagnosed acute maxillary sinusitis ( AMS ) . To study whether sinus ultrasound examination would help to detect those patients who benefit from antibiotic therapy . Design r - r A double-blind , r and omised , placebo-controlled multicentre trial . Setting r - r Nine primary care sites in Finl and . Subjects r - r 150 adult patients ( mean age 39.7 years ) with a clinical diagnosis of sinusitis . Intervention r - r Antibiotics ( amoxicillin 750 mg 2 2 , doxycycline 100 mg 2 2 or penicillin V 1500 mg 2 2 ) or placebo twice daily for 7 days ; all patients were examined with sinus ultrasound after r and omisation . Main outcome measure r - r Clinical success ( patients ' report of recovery ) in telephone interview at 2 weeks . Results r - r A total of 146 patients completed the 2-week follow-up . Patients receiving antibiotics achieved a slightly higher rate of clinical success than patients receiving placebo ( 80 % vs 66 % ; p=0.068 ) . Conclusions r - r Antibiotics hasten symptom relief in AMS . Yet many patients recover in 2 weeks without antimicrobial treatment . Only half of patients with a clinical diagnosis of AMS have sinusitis in ultrasound examination BACKGROUND Acute rhinosinusitis is one of the most common reasons for prescribing antibiotics in primary care . However , it is not clear whether antibiotics improve the outcome for patients with clinical ly diagnosed acute rhinosinusitis . We evaluated the effect of a combination product of amoxicillin-potassium clavulanate on adults with acute rhinosinusitis that was clinical ly diagnosed in a general practice setting . METHODS We conducted a r and omized , placebo-controlled , double 
    Output:
    
REVIEW ER 'S CONCLUSIONS For children with persistent nasal discharge or older children with radiographically confirmed sinusitis , the available evidence suggests that antibiotics given for 10 days will reduce the probability of persistence in the short to medium-term .