More evidence antibiotics do NOT help most people with sinusitis

I’ve told patients for years that antibiotics usually are NOT helpful for acute sinusitis. Why? Less than 10% of cases are bacterial.

Now new guidelines give me more support. They recommend waiting LONGER before giving an antibiotic … and giving it for a SHORTER time.

Here’s what the experts at Prescriber’s Letter are telling doctors:

Save antibiotics for a patient who has sinus symptoms for 10 days or more without improvement.

Also use an antibiotic for a patient with severe symptoms … fever 102ºF or higher AND purulent nasal discharge or facial pain for 3-4 days.

Also use an antibiotic for sinusitis if the patient had a cold for 5 to 6 days, got better, but now is worse.

They also advise:

Continue to recommend supportive measures … fluids, analgesics (ibuprofen, etc), and nasal irrigation.

Caution patients using neti pots to keep them clean to avoid infection.

Patients often swear by decongestants and/or antihistamines for symptoms … but they aren’t proven to help. Consider using a nasal steroid for stuffiness … especially if patients have allergies.

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