Risk factors of acute bacterial paranasal sinusitis in children: a case control study

Acute bacterial paranasal sinusitis is a common infection in children. The aim of this study was to analyze risk factors associated with acute bacterial paranasal sinusitis in children. Children aged 4 to 18 years were enrolled and received questionnaire survey from January 2020 to December 2021. Participants with a diagnosis of acute bacterial paranasal sinusitis received antibiotic treatment and were followed to evaluate the treatment outcome. A total of 228 participants was enrolled and divided to 3 groups, including acute bacterial paranasal sinusitis, allergic rhinitis without acute bacterial paranasal sinusitis and control group. Children having acute bacterial paranasal sinusitis were significantly younger than those who did not have (p = 0.02). Children with acute bacterial paranasal sinusitis had significantly higher rates of residential incense burning every day (p = 0.01) and antibiotic use within three months (p < 0.001). Multivariable logistic regression analysis showed that incense burning every day (aOR 2.45 [95% CI 1.25, 4.80], p < 0.001) and antibiotic use within three months (aOR 8.04 [95% CI 3.92, 16.50], p < 0.001) were significant risk factors of acute bacterial paranasal sinusitis. Nose blowing did not predispose to acute bacterial paranasal sinusitis, and did correlate with a favorable treatment response. Nasal irrigation was not beneficial to antibiotic treatment response of sinusitis. Exposure to residential incense and antibiotic use within three months were significant risk factors for acute bacterial paranasal sinusitis in children. Nose blowing exhibited no detrimental effect, while nasal irrigation showed no significant beneficial effect on either the occurrence or treatment outcome.