[What is the evidence for non-antibiotic drug therapy of Rhinosinusitis?].

The German AWMF-guideline for rhinosinusitis and nasal polyps is to be reassessed. By searching the literature for the reevaluation we investigate in this systematic review to what extent existing recommendations can be affirmed, have to be changed or if there are new recommendations to give.We searched PUBMED, MEDLINE and other databases via MEDPILOT, and the Cochrane Central Register of Controlled Trials without limiting the publication date range. Relevant clinical trials identified by 2 reviewers out of the search results were assessed for their methodical quality using an extended Jadad scale. Datas were extracted and study design, therapy/application, control group and results were analysed. Furthermore, levels of evidence for the different therapeutics have been determined.Out of 1 346 search results 227 potentially eligible trials were identified; for this review we considered only the 47 trials published since 01/2006. Former recommendations are mainly supported by the identified relevant publications and several Cochrane reviews published in the last years.Levels of evidence are Ia for topical and systemic corticosteroid therapy for acute and chronic rhinosinusitis. Additionally, there is evidence that the application of saline solutions is useful not only for chronic but also for acute rhinosinusitis. New therapy options are under examination, but there is not enough evidence for adding them to actual recommendations.