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Antibiotics are Ineffective for Sinus Infections

Posted on: Saturday, 15 March 2008, 00:00 CDT

British researchers are calling on doctors to cut back on prescribing antibiotics to patients with common sinus infections because the drugs don’t work. 

An analysis of nine trials published in the journal The Lancet found antibiotics were ineffective treatments even in people who had been ill for more seven days.
 
Sinusitis is an infection of the sinuses, small air pockets inside the cheekbones and forehead. Infected sinuses can cause blocked and runny noses, sinus pain, and high temperature. It is a very common occurrence, and often follows a cold or flu. According to BBC News, 1-5% of adults are diagnosed every with a sinus infection, around 90 percent of which are given antibiotic prescriptions.   

Current guidelines advise doctors to prescribe antibiotics only when the patient has been ill for seven to ten days, since an illness of this length was thought to indicate a bacterial rather than viral infection.

But the latest research, which examined how long 2,600 patients were ill before receiving treatment, found the time duration of the illness is not a good predictor of whether antibiotics will be effective.

Based on their work, the researchers concluded that antibiotics are not justified, even in patients who have been ill for longer over a week, because of the side-effects, costs and the risk of resistance. The data supported their conclusion, finding that 15 patients would need to be treated before even one would be cured with antibiotics.

Dr Jim Young from the Basel Institute for Clinical Epidemiology in Switzerland, the study’s leader, told BBC News, "If a patient comes to the GP and says they have had the complaint for seven to 10 days that's not a good enough reason for giving them the antibiotic."

He added that a rational approach for doctors would be to advise their patients to return if symptoms continue or got worse for another week.

This week, the National Institute for Clinical and health Excellence (NICE) published a draft guidance advising doctors against prescribing antibiotics or issuing delayed prescriptions that patients can use only if they do not improve over time.

Dr Ian Williamson, the study’s co-author, a GP in Southampton and researcher at Southampton University, said sinusitis was a terrible condition and people expected to get antibiotics from their GP to help them.

"Antibiotics really don't look as if they work.

"We have found that antibiotics aren't effective for sore throats and ear infections but sinusitis, which is similar, is the one that people are slightly more die hard about."

Professor Steve Field, chair of Britain’s Royal College of GPs, said doctors had been working hard to reduce antibiotic use for sinusitis in recent years, but the drug was likely still overprescribed. 

"This gives reassurance to GPs that even if patients have specific symptoms, it's unlikely antibiotics are going to make a dramatic difference."

He recommended that those suffering from sinus infections might relieve symptoms with steam, paracetamol and rest.

"You don't need to see the GP unless you've been ill for a week."

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