Sinus problems? Forget the antibiotics

Antibiotics provide little help to people with sinus infections, according to a study that suggests doctors are prescribing the drugs too often.

The study appearing in Wednesday's Journal of the American Medical Association found that using the common antibiotic amoxicillin for patients with acute uncomplicated rhinosinusitis "did not result in a significant difference in symptoms compared to patients who received placebo".

"Patients don't get better faster or have fewer symptoms when they get antibiotics," said Jay Piccirillo of Washington University in St Louis, Missouri, 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."

Antibiotics are commonly used to treat the condition, which involves inflammation of the nasal cavity and sinuses, even though there is limited evidence supporting their effectiveness, the researchers said, warning about the dangers of overuse of antibiotics.

The study authors said one in five antibiotics prescribed for adults in the United States is for sinus infections, and that many people come to expect this treatment.

"We feel antibiotics are overused in the primary-care setting," says Jane Garbutt, a professor of medicine and the paper's first author.

"There is a movement afoot, led by the Centres 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 research, one of many highlighting the problems of resistance to antibiotics, said such drugs should be reserved "for patients with moderately severe or severe symptoms".

Instead of giving antibiotics, such as the amoxicillin used in this study, the researchers suggest treating symptoms, such as pain, cough and congestion, along with watchful waiting to see whether further treatment is necessary.
The study included 166 adults with moderate, severe or very severe symptoms such as sinuses and nasal discharge that lasted between seven and 28 days.