Antibiotics Don’t Help Most Sinus Infections, Study Finds

TUESDAY, Feb. 14 (HealthDay News) — Treating a sinus infection
with antibiotics doesn’t speed recovery, new research shows.

“We did a randomized clinical trial among adults with a clinical
diagnosis of acute sinusitis, and found no benefit from the antibiotic
compared to the placebo for the treatment of acute sinusitis,” said study
author Dr. Jane Garbutt, a research associate professor of medicine and
pediatrics at Washington University School of Medicine in St. Louis.

Still, one in five antibiotic prescriptions for adults in the United
States are written for sinus infections, according to the study.

“Acute sinusitis is a miserable disease. People want something to make
them feel better, and there are not very many treatment options, so
patients ask their doctors for antibiotics. But, we think most of the
time, acute sinusitis is a viral infection, so antibiotics won’t help,”
said Garbutt.

Results of the study are published in the Feb. 15 issue of the
Journal of the American Medical Association.

Sinusitis is an inflammation of the sinus cavities. Pain in the
forehead is a common symptom, according to the National Institute of
Allergy and Infectious Diseases (NIAID). Another common symptom of
sinusitis is nasal secretions, which may drip down the back of the throat,
according to NIAID. Colds and allergies are common causes of sinusitis,
though sometimes bacteria are at fault.

Current guidelines from the U.S. Centers for Disease Control and
Prevention recommend antibiotics only for those with moderately severe or
severe symptoms.

Given the increase of bacteria resistance to antibiotics, the
researchers wanted to test their effectiveness, so they looked at 166
adults diagnosed with acute sinusitis. Thirty-six percent of the study
volunteers were male and 78 percent were white, according to the study.
People with chronic sinusitis (lasting more than 28 days) weren’t
included, as they may need a different treatment, the authors noted.

Study participants were randomly assigned to receive 10 days’ treatment
with either 1,500 milligrams of amoxicillin (an antibiotic) spread out
over three doses daily or a placebo. All of the volunteers were also given
treatments for pain, fever, cough and nasal congestion, and told to use
them as needed.

Symptoms and other measures of quality of life were measured in phone
interviews at three, seven, 10 and 28 days after starting treatment.

At day three, there was no difference in the symptoms between groups.
At day seven, there was a small improvement in the antibiotic group, but
Garbutt said the change was likely too small for a patient to even notice
a difference in symptoms. At 10 days, there was again no difference in
symptoms between the two groups.

By day 10, about 80 percent of those in both groups reported that their
symptoms were much improved or cured. At day 28, there was no difference
in relapse rates, the researchers said.

Garbutt said there were no statistically significant differences
between the groups for other measures, such as the need for medications to
relieve symptoms or days of missed work.

“Most people will get better from acute sinusitis on their own, but
many people feel if they’re not getting an antibiotic, nothing is being
done,” said Dr. Richard Lebowitz, an otolaryngologist at New York
University Langone Medical Center in New York City.

He said there are things people can do on their own that may help them
feel better faster. Saline irrigation of the sinuses can help, he said, as
can decongestant or mucous-thinning medications that are sold
over-the-counter.

“The average viral upper respiratory infection lasts one to two weeks,
and treatment of symptoms is probably the appropriate treatment up to that
point,” he said. But, if your infection lasts longer than a week or two,
or your symptoms suddenly get significantly worse, you should see your
doctor.

“Some people do have bacterial infections, and they can be hard to
identify,” said Garbutt, who also recommended following up with your
doctor if your symptoms don’t improve or they suddenly get worse.

More information

Learn more about sinusitis from the U.S. National Institute of Allergy and Infectious
Diseases
.

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