Format

Send to

Choose Destination
See comment in PubMed Commons below
Otolaryngol Head Neck Surg. 2014 Jan;150(1):28-33. doi: 10.1177/0194599813510891. Epub 2013 Nov 15.

No evidence for distinguishing bacterial from viral acute rhinosinusitis using fever and facial/dental pain: a systematic review of the evidence base.

Author information

  • 1Department of Otorhinolaryngology and Head & Neck Surgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands.

Abstract

OBJECTIVE:

To assess the diagnostic value of fever and facial and dental pain in adults suspected of acute bacterial rhinosinusitis.

DATA SOURCES:

PubMed, EMBASE, and the Cochrane Library.

REVIEW METHODS:

A comprehensive systematic search was performed on March 18, 2013. We included articles reporting studies on the diagnostic value of fever or facial and dental pain in patients suspected of acute bacterial rhinosinusitis. For included articles, the reported study design was assessed for directness of evidence and risk of bias. Prevalences, positive predictive values, and negative predictive values were extracted.

RESULTS:

Of 3171 unique records, we included 1 study with a high directness of evidence and a moderate risk of bias. The prior probability of bacterial rhinosinusitis was 0.29 (95% confidence interval: 0.24 to 0.35). We could not extract posterior probabilities with accompanying positive and negative predictive values. The study reported an odds ratio from univariate analysis for fever of 1.02 (0.52 to 2.00) and 1.65 (0.83 to 3.28) for facial and dental pain. In subsequent multivariate analysis, the odds ratio of facial and dental pain was 1.86 (1.06 to 3.29).

CONCLUSION AND RECOMMENDATION:

There is 1 study with moderate risk of bias, reporting data in such a manner that we could not assess the value of fever and facial and dental pain in adults suspected of an acute bacterial rhinosinusitis. Therefore, these symptoms should not be used in clinical practice to distinguish between a bacterial and viral source of acute rhinosinusitis or for decision making about prescribing antibiotic treatment.

KEYWORDS:

acute bacterial rhinosinusitis; acute rhinosinusitis; acute viral rhinosinusitis; diagnosis; evidence-based medicine; facial/dental pain; fever

PMID:
24357394
DOI:
10.1177/0194599813510891
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for HighWire
    Loading ...
    Support Center