Objective: To evaluate the efficacy of positive-pressure nasal irrigation devices in children with acute sinusitis, in addition to bacterial colonization of the irrigation device.

Method: We performed a randomized, prospective, controlled study of 80 children with acute sinusitis, aged between 3 and 15 years. Participants were randomly separated into two groups, where one group was treated using a squeezable bottle and the other group treated using a syringe. All patients were instructed to use a 1.25% buffered hypertonic solution for nasal irrigation twice daily for 2 weeks, in addition to amoxicillin-clavulanic acid. During this period, all participants recorded a 5S score, satisfaction score, any side effects and use of antihistamines. Parents were instructed to clean the device with soap after each use. After this period, the nasal irrigation devices were sent to a microbiological laboratory for bacterial identification.

Results: At the 2-week follow-up, improvement in both 5S and satisfaction scores were observed in both groups compared to baseline, which were significantly higher in the group treated with the squeezable bottle compared to the syringe. Few complaints were reported, and side effects were equal in both groups. The overall rate of bacterial contamination for both treatments was approximately 80%, but this did not translate into higher rates of infection amongst patients.

Conclusions: The use of a squeezable bottle for nasal irrigation in children with acute sinusitis was associated with further improvements in 5S and satisfaction scores compared to syringe use, and there were no significant differences in bacterial contamination between methods.