Professor and Residency Program Director Virginia Commonwealth University Children's Hospital of Richmond Virginia Commonwealth University School of Medicine MECHANICSVILLE, Virginia
Educational Objective: At the conclusion of this presentation, the participants should be able to describe the effect of guaifenesin on pediatric chronic rhinitis.
Objectives: To investigate the effectiveness of guaifenesin in the relief of nasal symptoms in children with chronic rhinitis (CR). We hypothesized that guaifenesin use over a 14 day study period would improve subjective nasal complaints in pediatric patients with chronic rhinitis, as measured by the SinoNasal-5 (SN-5) survey. We also hypothesized improvement in nasal volume and cross-sectional area with guaifenesin.
Study Design: Randomized, placebo controlled, parallel group, masked clinical trial.
Methods: The study consisted of a 14 day, randomized, placebo controlled, parallel group, masked clinical trial of oral guaifenesin for CR in children aged 7-18 years. A 2:1 ratio of subjects on active medication to placebo was used. The study was approved by the Western Institutional Review Board. On initial enrollment and at the conclusion of therapy, the SN-5 was completed by parents, acoustic rhinometry measurements performed, and mucus sampling for rheology was obtained. Results: 30 subjects were enrolled in the study, with 20 receiving guaifenesin and 10 placebo. Treatment with guaifenesin for 14 days produced a significant mean change towards clinical improvement in SN-5 scores compared with placebo (p=0.013). There was no significant difference in quality of life assessment scores between the two groups or in any of the acoustic rhinometry parameters. Many of the study subjects had difficulty producing a mucus sample sufficient for analysis.
Conclusions: Based upon our pilot data, it appears that guaifenesin treatment may produce objective improvements in pediatric patients with CR. Further research with larger sample sizes, inclusion of children younger than 6, and biophysical mucus analyses is warranted.