Antibiotic may not be best treatment for sinus infections

The Washington Post “The Checkup” blog reports, “A study released (recently) adds to the growing body of science suggesting that with some infections, including those of the sinuses, antibiotics aren’t the best course of treatment.”

Investigators found “that in their study of 166 adults with sinus infections, those who were given the antibiotic amoxicillin didn’t feel better any faster than those who received a placebo. People in both groups experienced about the same amount of relief after three days.”

The study is published in the Journal of the American Medical Association.

“‘We did see a difference on day seven, with more of those in the amoxicillin group experiencing relief, but the difference was so small – 0.19 on a scale of 0 to 3 – that it was barely detectable,’ said study author Dr. Jane M. Garbutt,” according to the Boston Globe.

Garbutt suggested that there was little difference seen, because “more often than not, these infections are viral … so antibiotics aren’t going to help.”

In addition, “while some people with sinus infections actually do have a bacterial infection, she added, they can’t be distinguished from those who have viruses since there’s no simple way to draw a sample from the sinus cavity.”

Bloomberg News adds, “One in five antibiotic prescriptions in the US are given to adults for sinus infections, the authors wrote. The findings suggest doctors avoid routine antibiotic treatment for patients with an uncomplicated sinus infection, they said in the study.”

MedPage Today reports, “Nasal obstruction recorded by the doctor was the only symptom that predicted benefit with antibiotic treatment at day seven,” according to researchers.

However, “these patients were almost five times as likely to improve by that time compared with those who didn’t initially report nasal obstruction (OR 4.59, 95% CI 1.16 to 18.12).”

Medscape reports, “‘Considering the public health threat posed by increasing antibiotic resistance, strong evidence of symptom relief is needed to justify prescribing of antibiotics for this usually self-limiting disease,’ the authors write.”

“CDC guidelines for the evaluation and treatment of adults with sinusitis … suggested that doctors only prescribe antibiotic treatment for the condition when patients have moderately severe or severe symptoms,” WebMD notes.

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