We included three trials (353 participants). Two trials compared intranasal corticosteroids to placebo and one trial compared intranasal corticosteroids to usual care; no trials studied oral corticosteroids. In the two placebo -controlled trials, no benefit of intranasal corticosteroids was demonstrated for duration or severity of symptoms. The risk of bias overall was low or unclear in these two trials. In a trial of 54 participants, the mean number of symptomatic days was in the placebo group, compared to in those using intranasal corticosteroids ( P value = ). A second trial of 199 participants reported no significant differences in the duration of symptoms. The single- blind trial in children aged two to 14 years, who were also receiving oral antibiotics, had inadequate reporting of outcome measures regarding symptom resolution. The overall risk of bias was high for this trial . Mean symptom severity scores were significantly lower in the group receiving intranasal steroids in addition to oral amoxicillin. One placebo - controlled trial reported the presence of rhinovirus in nasal aspirates and found no differences. Only one of the three trials reported on adverse events; no differences were found. Two trials reported secondary bacterial infections (one case of sinusitis , one case of acute otitis media ; both in the corticosteroid groups). A lack of comparable outcome measures meant that we were unable to combine the data .
Persons who are using drugs that suppress the immune system (., corticosteroids) are more susceptible to infections than healthy individuals. Chickenpox and measles , for example, can have a more serious or even fatal course in susceptible children or adults using corticosteroids. In children or adults who have not had these diseases or been properly immunized, particular care should be taken to avoid exposure. How the dose, route, and duration of corticosteroid administration affect the risk of developing a disseminated infection is not known. The contribution of the underlying disease and/or prior corticosteroid treatment to the risk is also not known. If a patient is exposed to chickenpox, prophylaxis with varicella zoster immune globulin (VZIG) may be indicated. If a patient is exposed to measles, prophylaxis with pooled intramuscular immunoglobulin ( IG ) may be indicated (see the respective package inserts for complete VZIG and IG prescribing information). If chickenpox or measles develops, treatment with antiviral agents may be considered.
Previously unvaccinated children less than 9 years of age require two doses of Influenza vaccine with a minimum interval of four weeks between doses. Those who have been previously vaccinated with influenza vaccine are recommended to receive one dose. Influenza vaccination will be available at the Vaughan Pediatric Clinic during your child’s regular scheduled appointments and on special Influenza vaccine clinic dates. Flu vaccine clinics are held without appointment on a first come first served basis, only on the dates specified. Caregivers will be encouraged to receive Influenza vaccine along with their children.