Antibiotics Do Not Help With Sinusitis: Study
February 15, 2012

Antibiotics Do Not Help With Sinusitis: Study

Researchers at the Washington University School of Medicine in St. Louis, Missouri have found that antibiotics do not significantly help in the healing of sinus infections.

According to Jay. Piccirillo, MD, professor of otolaryngology and the study´s senior author, “Our results show that antibiotics aren´t necessary for a basic sinus infection – most people get better on their own.”

Statistics show in the United States that one-in-five antibiotic prescriptions are for sinus infections. Couple that with the overuse of antibiotics, and more drug-resistant bacteria could show up on the medical radar. In order to combat this, doctors need to find the best treatment for sinus infections.

Jane M. Garbutt, MD, the paper´s first author says, “We feel antibiotics are overused in the primary-care setting. There is a movement afoot, led the by Centers for Disease Control and Prevention, to try to improve the judicious use of antibiotics. We hope this study provides scientific evidence that doctors can use with patients to explain that an antibiotic is not likely to help an acute sinus infection.”

The study looked at 166 adults with sinus infections. The patient´s symptoms had to be classified as moderate, severe or very severe. Patients had to have pain and tenderness in their face and sinuses and nasal discharge that lasted between seven and twenty-eight days. Those with secondary symptoms of chest or ear infection were not included in the study.

The participants were recruited by their primary care physicians and given either a ten-day course of amoxicillin or a course of placebo. All patients received medication for pain, fever, congestion and cough.

The patient´s symptoms were assessed at the start of the study, then at days three, seven, ten and twenty-eight. Participants answered a questionnaire assessing their quality-of-life called the Sinonasal Outcome Test-16 (SNOT-16).

According to the study day three found not difference between the antibiotic and placebo groups. Day seven found a slight improvement in the antibiotic group´s questionnaire scores, but the small change was not likely to represent a noticeable relief of symptoms, according to Garbutt.

By day ten the statistical improvement disappeared. Eighty percent of patients in both groups reported their symptoms were very much improved or cured.

According to Garbutt, “It´s a nasty disease. People have significant symptoms. They feel miserable and miss time from work. If an antibiotic is not going to be of any benefit, then what is? That´s a question we haven´t answered yet. But we are working on it.”

The report "Amoxicillin for acute rhinosinusitis: A randomized controlled trial" is published in the Journal of the American Medical Association (JAMA).


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